Provider Demographics
NPI:1811988918
Name:SCANDIA VOLUNTEER FIRE DEPARTMENT
Entity type:Organization
Organization Name:SCANDIA VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-757-5071
Mailing Address - Street 1:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:PA
Mailing Address - Zip Code:16345-0164
Mailing Address - Country:US
Mailing Address - Phone:814-757-8091
Mailing Address - Fax:814-757-8091
Practice Address - Street 1:5950 SCANDIA RD
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:PA
Practice Address - Zip Code:16345-6916
Practice Address - Country:US
Practice Address - Phone:814-757-8091
Practice Address - Fax:814-757-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-29
Last Update Date:2022-07-21
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2011-10-25
Provider Licenses
StateLicense IDTaxonomies
PA251V00000X
PA110413416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1765554OtherMEDICAL ASSISTANCE