Provider Demographics
NPI:1285785105
Name:CLAYMONT FIRE COMPANY 1
Entity type:Organization
Organization Name:CLAYMONT FIRE COMPANY 1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:NRPARAMEDIC
Authorized Official - Phone:302-798-6858
Mailing Address - Street 1:100 W COMMONS BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-2400
Mailing Address - Country:US
Mailing Address - Phone:800-697-5147
Mailing Address - Fax:888-456-3155
Practice Address - Street 1:3223 PHILADELPHIA PIKE
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-3101
Practice Address - Country:US
Practice Address - Phone:302-798-6858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE37373416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000537315Medicaid
DE0000537315Medicaid