Healthcare Provider Details

I. General information

NPI: 1588663348
Provider Name (Legal Business Name): CUMBERLAND RIVER VOLUNTEER FIRE DEPARTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13279 HWY 119 SOUTH
PARTRIDGE KY
40862-6417
US

IV. Provider business mailing address

836 4TH AVE
HUNTINGTON WV
25701-1407
US

V. Phone/Fax

Practice location:
  • Phone: 606-589-5930
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1635
License Number StateKY

VIII. Authorized Official

Name: TERESA OSBORNE
Title or Position: CHIEF
Credential:
Phone: 606-589-5930