Provider Demographics
NPI:1811168131
Name:MEMORIAL VOLUNTEER FIRE COMPANY
Entity type:Organization
Organization Name:MEMORIAL VOLUNTEER FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:GLASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-542-0012
Mailing Address - Street 1:100 W COMMONS BLVD SUITE 210
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-2400
Mailing Address - Country:US
Mailing Address - Phone:302-456-5725
Mailing Address - Fax:888-456-3155
Practice Address - Street 1:359 BAY AVENUE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4910
Practice Address - Country:US
Practice Address - Phone:302-422-8888
Practice Address - Fax:302-422-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE37813416L0300X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE492292Medicare PIN