Provider Demographics
NPI:1609855386
Name:GUMBORO VOLUNTEER FIRE CO.
Entity Type:Organization
Organization Name:GUMBORO VOLUNTEER FIRE CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-745-0836
Mailing Address - Street 1:37030 MILLSBORO HWY
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-3026
Mailing Address - Country:US
Mailing Address - Phone:302-238-7411
Mailing Address - Fax:302-238-7299
Practice Address - Street 1:37030 MILLSBORO HWY
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-3026
Practice Address - Country:US
Practice Address - Phone:302-238-7411
Practice Address - Fax:302-238-7299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE490169Medicare PIN