Provider Demographics
NPI:1316097967
Name:CONFLUENCE VOLUNTEER FIRE COMPANY
Entity type:Organization
Organization Name:CONFLUENCE VOLUNTEER FIRE COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:SUDER
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:814-395-5242
Mailing Address - Street 1:117 BAXTER ST
Mailing Address - Street 2:PO BOX 73
Mailing Address - City:CONFLUENCE
Mailing Address - State:PA
Mailing Address - Zip Code:15424-1045
Mailing Address - Country:US
Mailing Address - Phone:814-395-5242
Mailing Address - Fax:814-395-5242
Practice Address - Street 1:117 BAXTER ST
Practice Address - Street 2:
Practice Address - City:CONFLUENCE
Practice Address - State:PA
Practice Address - Zip Code:15424-1045
Practice Address - Country:US
Practice Address - Phone:814-395-5242
Practice Address - Fax:814-395-5242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA051543416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007826770001Medicaid
PA0007826770001Medicaid