Provider Demographics
NPI:1487624011
Name:MOUNTAIN TOP FIRE COMPANY
Entity type:Organization
Organization Name:MOUNTAIN TOP FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:TORMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-339-7410
Mailing Address - Street 1:PO BOX 50
Mailing Address - Street 2:392 STATE STREET
Mailing Address - City:SANDY RIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:16677-0050
Mailing Address - Country:US
Mailing Address - Phone:814-342-5014
Mailing Address - Fax:
Practice Address - Street 1:392 STATE ST
Practice Address - Street 2:
Practice Address - City:SANDY RIDGE
Practice Address - State:PA
Practice Address - Zip Code:16677-0050
Practice Address - Country:US
Practice Address - Phone:814-342-5014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA140083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA53750OtherHEALTH AMERICA
PW000281689OtherHIGHMARD
PA0007064790001Medicaid
PA281689OtherBLUE SHIELD
PA281689OtherUMWA
PA590008214OtherRR MEDICARE
PAM0281689OtherMAJOR MEDICAL
PAP021512OtherCHAMPUS
PA30430OtherGEISINGER
PA321407OtherUPMC HEALTH
PA0007064790001Medicaid
PA281689OtherBLUE SHIELD
PA53750OtherHEALTH AMERICA