Provider Demographics
NPI:1194711168
Name:BEAVER SPRINGS FIRE COMPANY
Entity type:Organization
Organization Name:BEAVER SPRINGS FIRE COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:EWIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-658-2117
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:BEAVER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17812-0129
Mailing Address - Country:US
Mailing Address - Phone:570-658-2117
Mailing Address - Fax:570-658-2127
Practice Address - Street 1:1015 CENTER AVE
Practice Address - Street 2:
Practice Address - City:BEAVER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:17812-0129
Practice Address - Country:US
Practice Address - Phone:570-658-2117
Practice Address - Fax:570-658-2127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014938870001Medicaid
PA120371Medicare PIN