Provider Demographics
NPI:1902959042
Name:ROCKWOOD FIRE DEPARTMENT
Entity Type:Organization
Organization Name:ROCKWOOD FIRE DEPARTMENT
Other - Org Name:ROCKWOOD VOL FIRE DEPT., INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-926-2259
Mailing Address - Street 1:630 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15557-1029
Mailing Address - Country:US
Mailing Address - Phone:814-926-4414
Mailing Address - Fax:
Practice Address - Street 1:630 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKWOOD
Practice Address - State:PA
Practice Address - Zip Code:15557-1029
Practice Address - Country:US
Practice Address - Phone:814-926-4414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-20
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA06071341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015602250001Medicaid
PA237520Medicare PIN