Provider Demographics
NPI:1780752691
Name:GREENFIELD TWP. VOL. FIRE CO.
Entity type:Organization
Organization Name:GREENFIELD TWP. VOL. FIRE CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:WHITELAVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-282-4981
Mailing Address - Street 1:424 ROUTE 106
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18407-3904
Mailing Address - Country:US
Mailing Address - Phone:570-282-5652
Mailing Address - Fax:570-282-5653
Practice Address - Street 1:424 ROUTE 106
Practice Address - Street 2:
Practice Address - City:GREENFIELD TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18407-3904
Practice Address - Country:US
Practice Address - Phone:570-282-4981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA021403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1628123OtherBC NEPA ACCESS CARE 2
PA590015556OtherRAILROAD MEDICARE
PA218247OtherBCBS SECURITY 65
PA2304952000OtherPERSONAL CHOICE
PA814485OtherFIRST PRIORITY HEALTH
PA998541OtherBCBS MAJOR MEDICAL
PA1011561250001Medicaid
PA998541OtherBCBS MAJOR MEDICAL