Provider Demographics
NPI:1992711790
Name:SUMMIT TOWNSHIP VOLUNTEER FIRE DEPARTMENT INCORPORATED
Entity type:Organization
Organization Name:SUMMIT TOWNSHIP VOLUNTEER FIRE DEPARTMENT INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CALVERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:814-382-1300
Mailing Address - Street 1:PO BOX 51
Mailing Address - Street 2:
Mailing Address - City:HARMONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16422-0051
Mailing Address - Country:US
Mailing Address - Phone:814-382-1300
Mailing Address - Fax:
Practice Address - Street 1:10870 PLUM ST.
Practice Address - Street 2:
Practice Address - City:HARMONSBURG
Practice Address - State:PA
Practice Address - Zip Code:16422
Practice Address - Country:US
Practice Address - Phone:814-382-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011064520004Medicaid
PA0011064520004OtherION HEALTH
PA0011064520004OtherION HEALTH
PA0011064520004Medicaid