Provider Demographics
NPI:1932548138
Name:GRASONVILLE VOLUNTEER FIRE DEPARTMENT INC
Entity Type:Organization
Organization Name:GRASONVILLE VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WERKHEISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-827-8100
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:GRASONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21638-0457
Mailing Address - Country:US
Mailing Address - Phone:410-827-8100
Mailing Address - Fax:410-827-4496
Practice Address - Street 1:4128 MAIN ST
Practice Address - Street 2:
Practice Address - City:GRASONVILLE
Practice Address - State:MD
Practice Address - Zip Code:21638-1251
Practice Address - Country:US
Practice Address - Phone:410-827-8100
Practice Address - Fax:410-827-4496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD422774300Medicaid
MD328644Medicare PIN