Provider Demographics
NPI:1316959729
Name:MODENA FIRE COMPANY NO 1
Entity type:Organization
Organization Name:MODENA FIRE COMPANY NO 1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:E.M.S. CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOWLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-384-3106
Mailing Address - Street 1:5 N BRANDYWINE AVE
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4432
Mailing Address - Country:US
Mailing Address - Phone:610-384-1311
Mailing Address - Fax:
Practice Address - Street 1:5 N BRANDYWINE AVE
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-4432
Practice Address - Country:US
Practice Address - Phone:610-384-1311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA050173416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007060580002Medicaid
PA0027023000OtherIBX
PA0770085000OtherIBX
PA0770085000OtherIBX