Healthcare Provider Details

I. General information

NPI: 1689672651
Provider Name (Legal Business Name): LETCHER VOLUNTARY FIRE AND RESCUE SQUAD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2429 HWY 7 SOUTH
JEREMIAH KY
41826-9082
US

IV. Provider business mailing address

PO BOX 89
JEREMIAH KY
41826-0089
US

V. Phone/Fax

Practice location:
  • Phone: 606-633-8058
  • Fax:
Mailing address:
  • Phone: 606-633-8058
  • Fax: 304-522-4222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1503
License Number StateKY

VIII. Authorized Official

Name: SHAWN GILLEY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 606-633-8058