Provider Demographics
NPI:1447246418
Name:FAIRVIEW FIRE CO 1
Entity type:Organization
Organization Name:FAIRVIEW FIRE CO 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:STRAUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-648-1700
Mailing Address - Street 1:1101 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:COAL TWP
Mailing Address - State:PA
Mailing Address - Zip Code:17866
Mailing Address - Country:US
Mailing Address - Phone:570-648-1700
Mailing Address - Fax:570-648-1490
Practice Address - Street 1:1101 W PINE ST
Practice Address - Street 2:
Practice Address - City:COAL TWP
Practice Address - State:PA
Practice Address - Zip Code:17866
Practice Address - Country:US
Practice Address - Phone:570-648-1700
Practice Address - Fax:570-648-1490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
208433OtherBCBS OF PA BLUE SHIELD
083209100OtherFEDERAL BLACK LUNG
PA208433OtherBLUE SHIELD
PA0011206580001Medicaid
PA208433OtherBLUE SHIELD
=========OtherTRI CARE NORTHEAST
590007803Medicare PIN
=========OtherTRI CARE MID ATL