1508877812 NPI number — BRIGHT VOLUNTEER FIRE COMPANY INC

Table of content: (NPI 1508877812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508877812 NPI number — BRIGHT VOLUNTEER FIRE COMPANY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIGHT VOLUNTEER FIRE COMPANY 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:
1508877812
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23759 BRIGHTWOOD DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCEBURG
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-637-3473
Provider Business Mailing Address Fax Number:
812-637-0161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23759 BRIGHTWOOD DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWRENCEBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-637-3473
Provider Business Practice Location Address Fax Number:
812-637-0161
Provider Enumeration Date:
08/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EBERHART
Authorized Official First Name:
GLENN
Authorized Official Middle Name:
KENDALL
Authorized Official Title or Position:
CHIEF & FIREFIGHTER/EMT
Authorized Official Telephone Number:
513-680-6630

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0017 , 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: 000000225694 . This is a "ANTHEM" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200379140A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000225694 . This is a "OTHER (NON-MEDICARE)" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com