Provider Demographics
NPI:1972601565
Name:THE COMMUNITY FIRE COMPANY OF RISING SUN INCORPORATED
Entity type:Organization
Organization Name:THE COMMUNITY FIRE COMPANY OF RISING SUN INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-350-3071
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:302-456-5725
Mailing Address - Fax:888-456-3155
Practice Address - Street 1:300 BIGGS HWY
Practice Address - Street 2:
Practice Address - City:RISING SUN
Practice Address - State:MD
Practice Address - Zip Code:21911-2245
Practice Address - Country:US
Practice Address - Phone:410-658-5115
Practice Address - Fax:410-658-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD530902600Medicaid
MDTR76OtherCAREFIRST BC/BS
MDN861OtherFEDERAL BLUE SHIELD
MD751RMedicare PIN
MDN861OtherFEDERAL BLUE SHIELD