Provider Demographics
NPI:1447209622
Name:FANNETT-METAL FIRE AND AMBULANCE COMPANY INC
Entity Type:Organization
Organization Name:FANNETT-METAL FIRE AND AMBULANCE COMPANY INC
Other - Org Name:FANNET-METAL AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:717-349-2212
Mailing Address - Street 1:4 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHIREMANSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17011-6326
Mailing Address - Country:US
Mailing Address - Phone:717-920-8460
Mailing Address - Fax:717-901-5731
Practice Address - Street 1:18778 DRY RUN RD W
Practice Address - Street 2:
Practice Address - City:DRY RUN
Practice Address - State:PA
Practice Address - Zip Code:17220-9700
Practice Address - Country:US
Practice Address - Phone:717-349-2212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007625580005Medicaid
PA282839Medicare ID - Type Unspecified