Provider Demographics
NPI:1356420046
Name:CITIZENS VOLUNTEER HOSE CO NO 1 OF BIRDVILLE PA
Entity type:Organization
Organization Name:CITIZENS VOLUNTEER HOSE CO NO 1 OF BIRDVILLE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:ERB
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:724-224-1912
Mailing Address - Street 1:965 BURTNER RD
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2300
Mailing Address - Country:US
Mailing Address - Phone:724-224-1912
Mailing Address - Fax:724-224-2791
Practice Address - Street 1:965 BURTNER RD
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2300
Practice Address - Country:US
Practice Address - Phone:724-224-1912
Practice Address - Fax:724-224-2791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA052083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
75183OtherUNISON HEALTHCARE
PA1005486Medicaid
PA0010771090002Medicaid
V0V25BOtherUPMC
0074629OtherAETNA US HEALTHCARE
281468OtherHIGHMARK
V0V25BOtherUPMC
75183OtherUNISON HEALTHCARE
281468OtherHIGHMARK