Provider Demographics
NPI:1437120193
Name:WILMINGTON MANOR VOLUNTEER FIRE COMPANY, INC.
Entity Type:Organization
Organization Name:WILMINGTON MANOR VOLUNTEER FIRE COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-438-5742
Mailing Address - Street 1:56 W. MAIN STREET
Mailing Address - Street 2:STE. 305
Mailing Address - City:CHIRSTIANA
Mailing Address - State:DE
Mailing Address - Zip Code:19702
Mailing Address - Country:US
Mailing Address - Phone:302-273-2247
Mailing Address - Fax:302-533-6818
Practice Address - Street 1:301 N DUPONT HWY
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-6433
Practice Address - Country:US
Practice Address - Phone:302-283-3300
Practice Address - Fax:302-283-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1FDKE30FOSHA81176341600000X
DE1FDWE35F6YHA53997341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000577515Medicaid
DE215640Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER