1568444859 NPI number — BURGHILL-VERNON VOLUNTEER FIRE DEPARTMENT ASSOCIATION

Table of content: (NPI 1568444859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568444859 NPI number — BURGHILL-VERNON VOLUNTEER FIRE DEPARTMENT ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BURGHILL-VERNON VOLUNTEER FIRE DEPARTMENT ASSOCIATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BURGHILL VERNON FIRE DEPT
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568444859
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6915 B STATE ROUTE 88
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINSMAN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44428-9790
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-448-6220
Provider Business Mailing Address Fax Number:
330-448-6220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6915 STATE ROUTE 88
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINSMAN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44428-9790
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-772-3013
Provider Business Practice Location Address Fax Number:
330-772-2874
Provider Enumeration Date:
11/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MOTT
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
BILLING CLERK
Authorized Official Telephone Number:
330-448-6220

Provider Taxonomy Codes

  • Taxonomy code: 261QP0904X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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