Provider Demographics
NPI:1760544589
Name:JARRETTSVILLE VOLUNTEER FIRE CO INC.
Entity Type:Organization
Organization Name:JARRETTSVILLE VOLUNTEER FIRE CO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-692-7890
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:JARRETTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21084-0007
Mailing Address - Country:US
Mailing Address - Phone:410-692-7890
Mailing Address - Fax:
Practice Address - Street 1:3825 FEDERAL HILL RD
Practice Address - Street 2:
Practice Address - City:JARRETTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21084
Practice Address - Country:US
Practice Address - Phone:410-692-7890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD792411900Medicaid
MDY901OtherCAREFIRST BLUE CROSS
MDS012OtherFEDERAL BLUE SHIELD
MD30219OtherHEALTH AMERICA
MD792411900Medicaid
590010387Medicare PIN