Provider Demographics
NPI:1689845901
Name:CLARKSVILLE & COMMUNITY VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:CLARKSVILLE & COMMUNITY VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE COMMANDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCCARTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-377-0458
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15322
Mailing Address - Country:US
Mailing Address - Phone:724-377-0381
Mailing Address - Fax:724-377-0381
Practice Address - Street 1:343 CENTER STREET
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15322
Practice Address - Country:US
Practice Address - Phone:724-377-0381
Practice Address - Fax:724-377-0381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA300409341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3000409OtherDEPT OF HEALTH