Provider Demographics
NPI:1295757730
Name:MILLVILLE COMMUNITY FIRE COMPANY
Entity type:Organization
Organization Name:MILLVILLE COMMUNITY FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-458-5783
Mailing Address - Street 1:PO BOX 80
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17846-0080
Mailing Address - Country:US
Mailing Address - Phone:570-458-5783
Mailing Address - Fax:
Practice Address - Street 1:28 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:PA
Practice Address - Zip Code:17846
Practice Address - Country:US
Practice Address - Phone:570-458-5783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0076344980002Medicaid
PA339426OtherHEALTH AMERICA/ASSURANCE
PA284949OtherHIGHMARK BS
PA998579OtherBLUE CROSS NEPA
PA284949OtherHIGHMARK BS
PA339426OtherHEALTH AMERICA/ASSURANCE