Healthcare Provider Details

I. General information

NPI: 1326077231
Provider Name (Legal Business Name): POE VOLUNTEER FIRE DEPARTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 08/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3619 E YODER RD
FORT WAYNE IN
46819-9794
US

IV. Provider business mailing address

PO BOX 501368
INDIANAPOLIS IN
46250-6368
US

V. Phone/Fax

Practice location:
  • Phone: 260-639-3992
  • Fax:
Mailing address:
  • Phone: 317-775-6751
  • Fax: 317-849-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0321
License Number StateIN

VIII. Authorized Official

Name: PAUL VONBANK
Title or Position: FIRE CHIEF
Credential:
Phone: 317-775-6753