Provider Demographics
NPI:1497851869
Name:ELSMERE FIRE COMPANY NO. 1
Entity type:Organization
Organization Name:ELSMERE FIRE COMPANY NO. 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REP
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-283-3300
Mailing Address - Street 1:71 OMEGA DR
Mailing Address - Street 2:BUILDING D
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2063
Mailing Address - Country:US
Mailing Address - Phone:302-283-3300
Mailing Address - Fax:302-283-3321
Practice Address - Street 1:1107 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2117
Practice Address - Country:US
Practice Address - Phone:302-999-0183
Practice Address - Fax:302-999-1721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE3534341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000541015Medicaid
DE226496Medicare PIN