Provider Demographics
NPI:1467427906
Name:HOCKESSIN FIRE COMPANY
Entity Type:Organization
Organization Name:HOCKESSIN FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-283-3300
Mailing Address - Street 1:71 OMEGA DR
Mailing Address - Street 2:BUILDING D
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2063
Mailing Address - Country:US
Mailing Address - Phone:302-283-3300
Mailing Address - Fax:302-283-3321
Practice Address - Street 1:1225 OLD LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-9560
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:2006-02-20
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1GBE4V1246F404758341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000622615Medicaid
DE235218Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER