Provider Demographics
NPI:1649487869
Name:CITY OF MANASSAS PARK FIRE & RESCUE DEPT.
Entity type:Organization
Organization Name:CITY OF MANASSAS PARK FIRE & RESCUE DEPT.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:O
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-331-3528
Mailing Address - Street 1:9080 MANASSAS DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS PARK
Mailing Address - State:VA
Mailing Address - Zip Code:20111-5235
Mailing Address - Country:US
Mailing Address - Phone:703-335-8845
Mailing Address - Fax:703-335-8865
Practice Address - Street 1:9080 MANASSAS DR
Practice Address - Street 2:
Practice Address - City:MANASSAS PARK
Practice Address - State:VA
Practice Address - Zip Code:20111-5235
Practice Address - Country:US
Practice Address - Phone:703-335-8845
Practice Address - Fax:703-335-8865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA337341600000X
VA341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190001960Medicare UPIN