Healthcare Provider Details

I. General information

NPI: 1376898502
Provider Name (Legal Business Name): HOAGLAND VOLUNTEER FIRE COMPANY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 MARYLAND AVE
ELKHART IN
46516-3358
US

IV. Provider business mailing address

11316 HOAGLAND RD
HOAGLAND IN
46745-9594
US

V. Phone/Fax

Practice location:
  • Phone: 574-293-3030
  • Fax: 574-294-1345
Mailing address:
  • Phone: 260-639-6161
  • Fax: 260-639-6161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0330
License Number StateIN

VIII. Authorized Official

Name: DALE M ROSENE
Title or Position: PRESIDENT
Credential:
Phone: 260-639-6161