Provider Demographics
NPI:1437158607
Name:NEWBERRY TOWNSHIP FIRE DEPARTMENT
Entity Type:Organization
Organization Name:NEWBERRY TOWNSHIP FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:HILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-938-3801
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-0726
Mailing Address - Country:US
Mailing Address - Phone:717-928-3801
Mailing Address - Fax:717-932-4034
Practice Address - Street 1:2145 YORK HAVEN RD
Practice Address - Street 2:
Practice Address - City:ETTERS
Practice Address - State:PA
Practice Address - Zip Code:17319-0277
Practice Address - Country:US
Practice Address - Phone:717-724-4141
Practice Address - Fax:717-214-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA050853416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007323430001Medicaid
PA000732343Medicaid
281675Medicare PIN