Provider Demographics
NPI:1831319136
Name:SPRINGFIELD VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:SPRINGFIELD VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VADZEMNIEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-922-3595
Mailing Address - Street 1:11959 MAIN ST.
Mailing Address - Street 2:PO BOX 79
Mailing Address - City:EAST SPRINGFEILD
Mailing Address - State:PA
Mailing Address - Zip Code:16411-0079
Mailing Address - Country:US
Mailing Address - Phone:814-922-3595
Mailing Address - Fax:814-922-3190
Practice Address - Street 1:11959 MAIN ST.
Practice Address - Street 2:
Practice Address - City:EAST SPRINGFEILD
Practice Address - State:PA
Practice Address - Zip Code:16411-0079
Practice Address - Country:US
Practice Address - Phone:814-922-3595
Practice Address - Fax:814-922-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA033803416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008873470002Medicaid
PA0008873470002Medicaid