Provider Demographics
NPI:1811080872
Name:SLIPPERY ROCK VFC AND RESCUE TEAM
Entity type:Organization
Organization Name:SLIPPERY ROCK VFC AND RESCUE TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAGGART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-468-1212
Mailing Address - Street 1:162 ELM ST
Mailing Address - Street 2:P O BOX 117
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-1520
Mailing Address - Country:US
Mailing Address - Phone:724-794-3817
Mailing Address - Fax:724-794-3482
Practice Address - Street 1:162 ELM ST
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-1520
Practice Address - Country:US
Practice Address - Phone:724-794-3817
Practice Address - Fax:724-794-3482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA060183416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014336070001Medicaid
PA0014336070001Medicaid