Healthcare Provider Details

I. General information

NPI: 1083744700
Provider Name (Legal Business Name): THE PERRYSVILLE FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 E 3RD ST
PERRYSVILLE OH
44864-9569
US

IV. Provider business mailing address

181 E 3RD ST
PERRYSVILLE OH
44864-9569
US

V. Phone/Fax

Practice location:
  • Phone: 419-938-5822
  • Fax: 419-938-8300
Mailing address:
  • Phone: 419-938-5822
  • Fax: 419-938-8300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VICKI L GORDON
Title or Position: EMS COORDINATOR
Credential:
Phone: 419-938-5822