Provider Demographics
NPI:1871564393
Name:MT PLEASANT TWP VOL FIRE DEPT NO 1
Entity type:Organization
Organization Name:MT PLEASANT TWP VOL FIRE DEPT NO 1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-757-6823
Mailing Address - Street 1:409 PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-1141
Mailing Address - Country:US
Mailing Address - Phone:724-887-6822
Mailing Address - Fax:724-887-9440
Practice Address - Street 1:5123 WATER ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-2554
Practice Address - Country:US
Practice Address - Phone:724-423-1829
Practice Address - Fax:724-423-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA011253416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011863000002Medicaid
PA0011863000002Medicaid
PA333048OtherHEALTH AMERICA
PA590006881OtherRR MEDICARE/PALMETTO GBA
PA251814OtherUPMC HEALTH
PA0011863000002Medicaid
PA333048OtherHEALTH AMERICA