Provider Demographics
NPI:1265579353
Name:QUEENSTOWN VOLUNTEER FIRE DEPARTMENT INC
Entity type:Organization
Organization Name:QUEENSTOWN VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:OLDERSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-988-1723
Mailing Address - Street 1:PO BOX 118
Mailing Address - Street 2:
Mailing Address - City:QUEENSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21658-0118
Mailing Address - Country:US
Mailing Address - Phone:410-827-8377
Mailing Address - Fax:
Practice Address - Street 1:7110 MAIN ST.
Practice Address - Street 2:
Practice Address - City:QUEENSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21658
Practice Address - Country:US
Practice Address - Phone:410-827-8377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD86JFOtherCAREFIRST BC/BS
MD181311OtherHEALTH AMERICA/ASSURANCE
MD414078800Medicaid
MDN601OtherFEDERAL BLUE SHIELD
MD181311OtherHEALTH AMERICA/ASSURANCE
MD587SMedicare PIN