Healthcare Provider Details

I. General information

NPI: 1144423385
Provider Name (Legal Business Name): TRIADELPHIA VOLUNTEER FIRE DEPARTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 NATIONAL ROAD
TRIADELPHIA WV
26059-0015
US

IV. Provider business mailing address

P.O. BOX 15
TRIADELPHIA WV
26059-0015
US

V. Phone/Fax

Practice location:
  • Phone: 304-547-5010
  • Fax: 304-547-4293
Mailing address:
  • Phone: 304-547-5010
  • Fax: 304-547-4293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateWV

VIII. Authorized Official

Name: MR. MIKE WHEELER
Title or Position: PROVIDER RELATIONS SPECIALIST
Credential:
Phone: 304-521-1576