Provider Demographics
NPI:1366610388
Name:MARSHALLS CREEK FIRE COMPANY
Entity type:Organization
Organization Name:MARSHALLS CREEK FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VITULLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-269-7798
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:MARSHALLS CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:18335-0001
Mailing Address - Country:US
Mailing Address - Phone:570-223-8445
Mailing Address - Fax:570-223-5620
Practice Address - Street 1:112 MARSHALLS CREEK RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18335-0001
Practice Address - Country:US
Practice Address - Phone:570-223-8445
Practice Address - Fax:570-223-5620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021169010001Medicaid
PA1021169010001Medicaid