Provider Demographics
NPI:1144228644
Name:POCOMOKE CITY VOLUNTEER AMBULANCE COMPANY INC.
Entity type:Organization
Organization Name:POCOMOKE CITY VOLUNTEER AMBULANCE COMPANY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:MR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:410-957-3600
Mailing Address - Street 1:137 8TH ST
Mailing Address - Street 2:P.O. BOX 36
Mailing Address - City:POCOMOKE CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21851-1128
Mailing Address - Country:US
Mailing Address - Phone:410-957-3600
Mailing Address - Fax:410-957-2221
Practice Address - Street 1:137 8TH ST
Practice Address - Street 2:
Practice Address - City:POCOMOKE CITY
Practice Address - State:MD
Practice Address - Zip Code:21851-1128
Practice Address - Country:US
Practice Address - Phone:410-957-3600
Practice Address - Fax:410-957-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD651QMedicare ID - Type UnspecifiedPROVIDER ID