Provider Demographics
NPI:1194820738
Name:TALLEYVILLE FIRE COMPANY, INC.
Entity type:Organization
Organization Name:TALLEYVILLE FIRE COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-478-1110
Mailing Address - Street 1:100 W COMMONS BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-2419
Mailing Address - Country:US
Mailing Address - Phone:800-697-5147
Mailing Address - Fax:888-456-3155
Practice Address - Street 1:3919 CONCORD PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803
Practice Address - Country:US
Practice Address - Phone:302-478-1110
Practice Address - Fax:302-478-0229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE3620341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000559515Medicaid
DE207458Medicare PIN