Provider Demographics
NPI:1497895163
Name:LAUREL FIRE DEPARTMENT INC.
Entity Type:Organization
Organization Name:LAUREL FIRE DEPARTMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-653-3557
Mailing Address - Street 1:PO BOX 375
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-0375
Mailing Address - Country:US
Mailing Address - Phone:302-653-3557
Mailing Address - Fax:302-653-3552
Practice Address - Street 1:205 W 10TH ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:DE
Practice Address - Zip Code:19956-1910
Practice Address - Country:US
Practice Address - Phone:302-653-3557
Practice Address - Fax:302-653-3552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA-81 B-81 C-813416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE284248Medicare PIN