Healthcare Provider Details

I. General information

NPI: 1871657551
Provider Name (Legal Business Name): ST. JOHNS VOLUNTEER FIRE & RESCUE DEPARTMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13860 WALNUT STREET
SAINT JOHNS OH
45884-0194
US

IV. Provider business mailing address

PO BOX 194 13860 WALNUT STREET
SAINT JOHNS OH
45884-0194
US

V. Phone/Fax

Practice location:
  • Phone: 419-738-7638
  • Fax:
Mailing address:
  • Phone: 419-738-7638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. RODNEY CAMPBELL
Title or Position: CHIEF
Credential: EMT-P
Phone: 419-568-3988