Provider Demographics
NPI:1710966502
Name:AVONDALE FIRE COMPANY EMS DIVISION INC
Entity Type:Organization
Organization Name:AVONDALE FIRE COMPANY EMS DIVISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:N
Authorized Official - Last Name:SWIFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-268-2486
Mailing Address - Street 1:23 FIREHOUSE WAY
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19311-1418
Mailing Address - Country:US
Mailing Address - Phone:610-268-2486
Mailing Address - Fax:610-268-3573
Practice Address - Street 1:23 FIREHOUSE WAY
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:PA
Practice Address - Zip Code:19311-1418
Practice Address - Country:US
Practice Address - Phone:610-268-2486
Practice Address - Fax:610-268-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD419086600Medicaid
PA0007717260002Medicaid
PA280032Medicare PIN
PA0007717260002Medicaid