=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003223199
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HARTFORD VOLUNTEER FIRE DEPARTMENT INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2014
-----------------------------------------------------
Last Update Date | 12/05/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 180 SMITH STREET
-----------------------------------------------------
City | CROTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43013
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-893-3291
-----------------------------------------------------
Fax | 740-893-3472
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2085
-----------------------------------------------------
City | MOUNT VERNON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43050-7285
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-893-3291
-----------------------------------------------------
Fax | 740-893-3472
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FIRE CHIEF
-----------------------------------------------------
Name | MICHAEL R RICHARDSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 740-893-3291
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------