Healthcare Provider Details

I. General information

NPI: 1902933682
Provider Name (Legal Business Name): COATESVILLE VOLUNTEER FIRE DEPARTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8098 MAIN ST.
COATESVILLE IN
46121
US

IV. Provider business mailing address

PO BOX 502250
INDIANAPOLIS IN
46250-7250
US

V. Phone/Fax

Practice location:
  • Phone: 765-386-2391
  • Fax: 765-386-7490
Mailing address:
  • Phone: 317-849-6628
  • Fax: 317-849-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0477
License Number StateIN

VIII. Authorized Official

Name: MR. JAMES B. ELLETT
Title or Position: EMS COORDINATOR
Credential:
Phone: 317-775-6753