Provider Demographics
NPI:1396097374
Name:BEECH CREEK-BLANCHARD VOLUNTEER FIRE COMPANY
Entity type:Organization
Organization Name:BEECH CREEK-BLANCHARD VOLUNTEER FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-962-2382
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:BEECH CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:16822-0144
Mailing Address - Country:US
Mailing Address - Phone:570-962-2382
Mailing Address - Fax:570-962-2333
Practice Address - Street 1:38 LOCUST ST
Practice Address - Street 2:
Practice Address - City:BEECH CREEK
Practice Address - State:PA
Practice Address - Zip Code:16822-6803
Practice Address - Country:US
Practice Address - Phone:570-962-2382
Practice Address - Fax:570-962-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027970720001Medicaid
P01149265Medicare PIN
PA267570Medicare PIN