Provider Demographics
NPI:1639220593
Name:WEST END FIRE COMPANY NO 3 OF PHOENIXVILLE
Entity Type:Organization
Organization Name:WEST END FIRE COMPANY NO 3 OF PHOENIXVILLE
Other - Org Name:WEST END FIRE CO #3
Other - Org Type:Other Name
Authorized Official - Title/Position:LIEUTENANT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:STALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-933-1140
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-0726
Mailing Address - Country:US
Mailing Address - Phone:717-724-4136
Mailing Address - Fax:717-635-6176
Practice Address - Street 1:801 W BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4214
Practice Address - Country:US
Practice Address - Phone:910-933-5160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA060373416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011699OtherKEYSTONE MERCY
PA0009463860003Medicaid
PA116429700OtherDEPT OF LABOR
PA590939012OtherPALMETTO
PA0027011000OtherINDEPENDENCE BLUE CROSS
PA31815OtherHEALTH PARTNERS
PA1011699OtherKEYSTONE MERCY