Provider Demographics
NPI:1194936989
Name:ELDRED BORO VOLUNTEER FIRE DEPARTMENT,INC.
Entity type:Organization
Organization Name:ELDRED BORO VOLUNTEER FIRE DEPARTMENT,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE CAPT.
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BALDONI
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:814-225-3126
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:5 PLATT STREET
Mailing Address - City:ELDRED
Mailing Address - State:PA
Mailing Address - Zip Code:16731-0146
Mailing Address - Country:US
Mailing Address - Phone:814-225-3126
Mailing Address - Fax:814-225-2503
Practice Address - Street 1:6 PLATT ST.
Practice Address - Street 2:
Practice Address - City:ELDRED
Practice Address - State:PA
Practice Address - Zip Code:16731-0146
Practice Address - Country:US
Practice Address - Phone:814-225-3126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELDRED BORO VOLUNTEER FIRE DEPARTMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-24
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04118341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance