Provider Demographics
NPI:1053470906
Name:RADNOR FIRE COMPANY OF WAYNE
Entity type:Organization
Organization Name:RADNOR FIRE COMPANY OF WAYNE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:610-687-3245
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-0031
Mailing Address - Country:US
Mailing Address - Phone:610-687-3245
Mailing Address - Fax:610-687-8849
Practice Address - Street 1:121 S WAYNE AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-4116
Practice Address - Country:US
Practice Address - Phone:610-687-3245
Practice Address - Fax:610-687-8849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012916190002Medicaid
590009640OtherRAILROAD MEDICARE
PA0012916190002Medicaid