Provider Demographics
NPI:1598863102
Name:WEST GROVE FIRE COMPANY
Entity Type:Organization
Organization Name:WEST GROVE FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-869-9326
Mailing Address - Street 1:PO BOX 329
Mailing Address - Street 2:
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-0329
Mailing Address - Country:US
Mailing Address - Phone:717-464-0724
Mailing Address - Fax:717-464-9775
Practice Address - Street 1:101 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-1111
Practice Address - Country:US
Practice Address - Phone:610-869-9326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03183341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07127250001Medicaid
PA590012505OtherRRMC
PA281110Medicare PIN