Healthcare Provider Details

I. General information

NPI: 1073118105
Provider Name (Legal Business Name): SHARPSVILLE VOLUNTEER FIRE DEPT CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 W VINE ST
SHARPSVILLE IN
46068-8927
US

IV. Provider business mailing address

PO BOX 56002
INDIANAPOLIS IN
46256-0002
US

V. Phone/Fax

Practice location:
  • Phone: 317-775-6753
  • Fax: 317-849-6632
Mailing address:
  • Phone: 317-775-6753
  • Fax: 317-849-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

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