1386642288 NPI number — CARTHAGE VOLUNTEER FIRE DEPARTMENT OF RUSH COUNTY INC

Table of content: (NPI 1386642288)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386642288 NPI number — CARTHAGE VOLUNTEER FIRE DEPARTMENT OF RUSH COUNTY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARTHAGE VOLUNTEER FIRE DEPARTMENT OF RUSH COUNTY INC
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:
Provider Other Organization Name Type Code:
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:
1386642288
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
836 4TH AVE.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-676-4785
Provider Business Mailing Address Fax Number:
304-522-4222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
208 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARTHAGE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46115-9629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-565-1234
Provider Business Practice Location Address Fax Number:
765-565-6433
Provider Enumeration Date:
07/13/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DUNCAN
Authorized Official First Name:
BOYD
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
765-565-1234

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  387 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000214149 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 590015637 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200239270A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".