Healthcare Provider Details

I. General information

NPI: 1104825595
Provider Name (Legal Business Name): PETERSBURG FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3018 2ND STREET
PETERSBURG KY
41080-0068
US

IV. Provider business mailing address

836 4TH AVE
HUNTINGTON WV
25701-1407
US

V. Phone/Fax

Practice location:
  • Phone: 859-586-6610
  • Fax: 859-586-4688
Mailing address:
  • Phone: 800-676-4785
  • Fax: 304-522-4222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1581
License Number StateKY

VIII. Authorized Official

Name: BILL BIRKLE
Title or Position: CHIEF
Credential:
Phone: 859-586-6610