Provider Demographics
NPI:1710318555
Name:EXETER TOWNSHIP VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:EXETER TOWNSHIP VOLUNTEER FIRE DEPARTMENT
Other - Org Name:EXETER TOWNSHIP FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:DEPUTY CHIEF - EMS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:610-779-8848
Mailing Address - Street 1:46 W 33RD ST
Mailing Address - Street 2:PO BOX 3827
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-2904
Mailing Address - Country:US
Mailing Address - Phone:610-779-8848
Mailing Address - Fax:
Practice Address - Street 1:46 W 33RD ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2904
Practice Address - Country:US
Practice Address - Phone:610-779-8848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
PA15006341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulance
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030300890001Medicaid
P01492700Medicare PIN
PA409175Medicare PIN