1770782518 NPI number — NEW CREEK VOLUNTEER FIRE DEPARTMENT

Table of content: (NPI 1770782518)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770782518 NPI number — NEW CREEK VOLUNTEER FIRE DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW CREEK VOLUNTEER FIRE DEPARTMENT
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:
1770782518
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW CREEK
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26743-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-788-4041
Provider Business Mailing Address Fax Number:
304-788-4041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
STATE ROUTE 972
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CREEK
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-788-4041
Provider Business Practice Location Address Fax Number:
304-788-4041
Provider Enumeration Date:
07/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BIGGS
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
Authorized Official Title or Position:
ASST. FIRE CHIEF
Authorized Official Telephone Number:
304-788-4041

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  62953 , 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)

  • Identifier: 001995687 . This is a "MT STATE BCBS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 1074759 . This is a "WV WORKERS COMP" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: P00442956 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 3810010549 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com