Provider Demographics
NPI:1134152622
Name:SPRINGDALE VOLUNTEER FIRE DEPT
Entity type:Organization
Organization Name:SPRINGDALE VOLUNTEER FIRE DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-274-5090
Mailing Address - Street 1:845 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15144-1636
Mailing Address - Country:US
Mailing Address - Phone:724-274-5090
Mailing Address - Fax:724-274-0451
Practice Address - Street 1:845 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:PA
Practice Address - Zip Code:15144-1636
Practice Address - Country:US
Practice Address - Phone:724-274-5090
Practice Address - Fax:724-274-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA033013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011887160001Medicaid
PA207357OtherHIGHMARK MEDICARE SERVICES