Healthcare Provider Details

I. General information

NPI: 1063412997
Provider Name (Legal Business Name): INDEPENDENCE FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 DELAWARE CROSSING
INDEPENDENCE KY
41051
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251-9900
US

V. Phone/Fax

Practice location:
  • Phone: 859-356-2011
  • Fax: 859-356-3624
Mailing address:
  • Phone: 800-962-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1475
License Number StateKY

VIII. Authorized Official

Name: WILLIAM SCOTT BREEZE
Title or Position: CHIEF
Credential:
Phone: 859-356-2011