Provider Demographics
NPI:1720114960
Name:CENTERVILLE VOLUNTEER FIRE DEPARTMENT AND LADIES AUXILLIARY
Entity Type:Organization
Organization Name:CENTERVILLE VOLUNTEER FIRE DEPARTMENT AND LADIES AUXILLIARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-581-1010
Mailing Address - Street 1:PO BOX 179
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16404-0179
Mailing Address - Country:US
Mailing Address - Phone:814-581-1010
Mailing Address - Fax:814-581-1020
Practice Address - Street 1:39567 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:16404-1125
Practice Address - Country:US
Practice Address - Phone:801-581-1010
Practice Address - Fax:814-581-1020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013964140006Medicaid
PA0013964140006Medicaid
PA166490Medicare PIN