Basic Information
| Provider Information | |||||||||
| NPI: | 1992854459 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MINQUADALE FIRE CO INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | D71 OMEGA DRIVE | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3022833300 | ||||||||
| FaxNumber: | 3022833321 | ||||||||
| Practice Location | |||||||||
| Address1: | 129 E HAZELDELL AVE | ||||||||
| Address2: | |||||||||
| City: | NEW CASTLE | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197201346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026520986 | ||||||||
| FaxNumber: | 3026524507 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 06/06/2013 | ||||||||
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| AuthorizedOfficialLastName: | DAY | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | FRANCIS | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF | ||||||||
| AuthorizedOfficialTelephone: | 3026520986 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 341600000X | DE | Y | Transportation Services | Ambulance |
ID Information
| ID | Type | State | Issuer | Description | 0000601715 | 05 | DE | MEDICAID | 590012114 | 01 | RAILROAD | OTHER |