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General NPI Number Information
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NPI Number | 1013142595
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Entity Type | Organization
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Legal Business Name | FAIRVIEW PARK VOLUNTEER FIRE DEPARTMENT
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Dates
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Enumeration Date | 05/27/2009
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Last Update Date | 05/27/2009
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Provider Practice Location Address
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Address Line | 281 S WASHINGTON ST
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City | CLINTON
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State | IN
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Zip | 47842-7010
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Country | US
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Telephone | 765-832-7271
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Fax |
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Provider Business Mailing Address
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Address Line | 281 S WASHINGTON ST
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City | CLINTON
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State | IN
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Zip | 47842-7010
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Country | US
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Telephone | 765-832-7271
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Fax |
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Authorized Official
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Title or Position | A-EMT/ F.F. / EMS TRAINING OFFICER
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Name | MR. BRIAN KEITH MORRIS
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Credential | EMS DIRECTOR
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Telephone | 765-832-7271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1094
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License Number State | IN
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