Healthcare Provider Details

I. General information

NPI: 1508856899
Provider Name (Legal Business Name): MORGANTOWN RURAL FIRE DEPARTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 01/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 N HIGHLAND ST
MORGANTOWN IN
46160-9724
US

IV. Provider business mailing address

269 N HIGHLAND ST
MORGANTOWN IN
46160-9724
US

V. Phone/Fax

Practice location:
  • Phone: 812-597-1120
  • Fax: 812-597-0452
Mailing address:
  • Phone: 812-597-1120
  • Fax: 812-597-0452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0670
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. CLYCE SMITH
Title or Position: FIRE CHIEF
Credential:
Phone: 812-597-1120