Provider Demographics
NPI:1770538779
Name:MELFA VOLUNTEER FIRE AND RESCUE COMPANY INCORPORATED
Entity type:Organization
Organization Name:MELFA VOLUNTEER FIRE AND RESCUE COMPANY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-787-0910
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:MELFA
Mailing Address - State:VA
Mailing Address - Zip Code:23410-0100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28328 HATTON ST
Practice Address - Street 2:
Practice Address - City:MELFA
Practice Address - State:VA
Practice Address - Zip Code:23410-3707
Practice Address - Country:US
Practice Address - Phone:757-787-0910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA352341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009013407Medicaid
590013495OtherRR CARE
21183OtherOPTIMA
075731OtherBCBS
21183OtherOPTIMA
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