Provider Demographics
NPI:1851502587
Name:ELDRED TOWNSHIP VOLUNTEER FIRE COMPANY
Entity Type:Organization
Organization Name:ELDRED TOWNSHIP VOLUNTEER FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:WHITFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:570-435-0211
Mailing Address - Street 1:5556 WARRENSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-9022
Mailing Address - Country:US
Mailing Address - Phone:570-435-0211
Mailing Address - Fax:570-435-3190
Practice Address - Street 1:5556 WARRENSVILLE RD
Practice Address - Street 2:
Practice Address - City:MONTOURSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17754-9022
Practice Address - Country:US
Practice Address - Phone:570-435-0211
Practice Address - Fax:570-435-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015399920001Medicaid
PA285654Medicare PIN