Provider Demographics
NPI:1649366782
Name:SINNAMAHONING VOL FIRE DEPT AND AMBULANCE SERVICE
Entity type:Organization
Organization Name:SINNAMAHONING VOL FIRE DEPT AND AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:KEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-546-2487
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-0207
Mailing Address - Country:US
Mailing Address - Phone:484-664-2007
Mailing Address - Fax:484-664-2015
Practice Address - Street 1:186 RAILROAD STREET
Practice Address - Street 2:
Practice Address - City:SINNAMAHONING
Practice Address - State:PA
Practice Address - Zip Code:15861
Practice Address - Country:US
Practice Address - Phone:814-546-2487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA06087341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008958860002Medicaid
PA201955Medicare PIN