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General NPI Number Information
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NPI Number | 1134289903
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Entity Type | Organization
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Legal Business Name | SOMERTON VOLUNTEER FIRE DEPARTMENT
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 55717 WASHINGTON ST
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City | SOMERTON
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State | OH
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Zip | 43713-9570
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Country | US
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Telephone | 740-757-2565
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Fax |
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Provider Business Mailing Address
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Address Line | 55717 WASHINGTON ST
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City | SOMERTON
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State | OH
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Zip | 43713-9570
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Country | US
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Telephone | 740-757-2565
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Fax |
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Authorized Official
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Title or Position | ASST FISCAL OFFICER
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Name | MRS. TANYA L BLACKSTONE
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Credential |
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Telephone | 740-757-2565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 021021300
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License Number State | OH
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