1760813448 NPI number — MATHIAS-BAKER VOLUNTEER FIRE COMPANY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760813448 NPI number — MATHIAS-BAKER VOLUNTEER FIRE COMPANY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MATHIAS-BAKER VOLUNTEER FIRE COMPANY
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:
1760813448
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PADUCAH
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42002-9150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-744-9600
Provider Business Mailing Address Fax Number:
270-744-0834

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12412 SR 259
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MATHIAS
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-820-6648
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/06/2013

Additional Information

Authorized Official

Authorized Official Last Name:
SANTANA
Authorized Official First Name:
ALEXANDER
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS CAPTAIN
Authorized Official Telephone Number:
304-820-6648

Provider Taxonomy Codes

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

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





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