1659379550 NPI number — ALEXANDRIA FIRE DISTRICT

Table of content: (NPI 1659379550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659379550 NPI number — ALEXANDRIA FIRE DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALEXANDRIA FIRE DISTRICT
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:
1659379550
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
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:
25701-1407
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:
7951 ALEXANDRIA PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41001-1159
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-635-5991
Provider Business Practice Location Address Fax Number:
859-635-5999
Provider Enumeration Date:
07/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CICCARELLA
Authorized Official First Name:
JIM
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
859-635-5991

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1558 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000192807 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 0973497 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 55000277 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50013570 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 56016744 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2822889000 . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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