1699004895 NPI number — BARLOW VOLUNTEER FIRE DEPARTMENT INC.

Table of content: (NPI 1699004895)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699004895 NPI number — BARLOW VOLUNTEER FIRE DEPARTMENT INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARLOW VOLUNTEER FIRE DEPARTMENT 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:
1699004895
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10361 SPARTAN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45215-1220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-612-3193
Provider Business Mailing Address Fax Number:
513-772-4464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
549 WARRIOR DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARLOW
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-678-2726
Provider Business Practice Location Address Fax Number:
740-678-2516
Provider Enumeration Date:
12/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
EDDLEBLUTE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
T
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
740-525-7078

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  020346650 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000648624 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3022562 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00808671 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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