1649462656 NPI number — VALLEY VOLUNTEER FIRE DEPARTMENT, INC

Table of content: (NPI 1649462656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649462656 NPI number — VALLEY VOLUNTEER FIRE DEPARTMENT, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY 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:
6
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:
1649462656
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2021
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:
270-744-8642

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1946 TATE SPRINGS ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIG STONE GAP
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-523-1804
Provider Business Practice Location Address Fax Number:
276-523-0080
Provider Enumeration Date:
08/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BUSH
Authorized Official First Name:
CARLOS
Authorized Official Middle Name:
RAY
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
276-523-1804

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  739 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com