Provider Demographics
NPI:1942364294
Name:IRWIN VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:IRWIN VOLUNTEER FIRE DEPARTMENT
Other - Org Name:IRWIN VFD AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-864-3106
Mailing Address - Street 1:518 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642
Mailing Address - Country:US
Mailing Address - Phone:724-864-3106
Mailing Address - Fax:724-864-3107
Practice Address - Street 1:518 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642
Practice Address - Country:US
Practice Address - Phone:724-864-3106
Practice Address - Fax:724-864-3107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA060133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1120710Medicaid
PA209607Medicare ID - Type Unspecified