Healthcare Provider Details

I. General information

NPI: 1528186475
Provider Name (Legal Business Name): EAST BURRILLVILLE FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 OAKLAND SCHOOL ST
OAKLAND RI
02859-1011
US

IV. Provider business mailing address

PO BOX 8879
CRANSTON RI
02920-0879
US

V. Phone/Fax

Practice location:
  • Phone: 401-568-5720
  • Fax:
Mailing address:
  • Phone: 401-572-3120
  • Fax: 401-572-3351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number27
License Number StateRI

VIII. Authorized Official

Name: JOSEPH BERTHOLIC
Title or Position: FIRE CHIEF
Credential:
Phone: 401-568-5720