Provider Demographics
NPI:1619355377
Name:KREAMER VOLUNTEER FIRE COMPANY
Entity Type:Organization
Organization Name:KREAMER VOLUNTEER FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-837-8977
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:KREAMER
Mailing Address - State:PA
Mailing Address - Zip Code:17833-0173
Mailing Address - Country:US
Mailing Address - Phone:570-837-8977
Mailing Address - Fax:570-837-1707
Practice Address - Street 1:37 MANOR DR
Practice Address - Street 2:
Practice Address - City:KREAMER
Practice Address - State:PA
Practice Address - Zip Code:17833-0173
Practice Address - Country:US
Practice Address - Phone:570-837-8977
Practice Address - Fax:570-837-1707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030646030001Medicaid
PA1030646030001Medicaid