Provider Demographics
NPI:1780802959
Name:WHITEFORD VOLUNTEER FIRE COMPANY INC
Entity type:Organization
Organization Name:WHITEFORD VOLUNTEER FIRE COMPANY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-452-8425
Mailing Address - Street 1:PO BOX 222
Mailing Address - Street 2:
Mailing Address - City:WHITEFORD
Mailing Address - State:MD
Mailing Address - Zip Code:21160-0222
Mailing Address - Country:US
Mailing Address - Phone:410-452-8425
Mailing Address - Fax:
Practice Address - Street 1:1407 PYLESVILLE ROAD
Practice Address - Street 2:
Practice Address - City:WHITEFORD
Practice Address - State:MD
Practice Address - Zip Code:21160
Practice Address - Country:US
Practice Address - Phone:410-452-8425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD237100600Medicaid
MDTR13OtherCAREFIRST BC/BS
MDS044OtherFEDERAL BLUE SHIELD
MDS044OtherFEDERAL BLUE SHIELD
590011499Medicare PIN