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General NPI Number Information
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NPI Number | 1144228354
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Entity Type | Organization
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Legal Business Name | KENTON COMMUNITY VOLUTNEER FIRE DEPARTMENT INC
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 14081 DECOURSEY PIKE
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City | KENTON
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State | KY
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Zip | 41063
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Country | US
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Telephone | 859-356-3434
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Fax |
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Provider Business Mailing Address
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Address Line | 10361 SPARTAN DR
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City | CINCINNATI
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State | OH
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Zip | 45215-1220
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Country | US
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Telephone | 800-962-1484
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Fax |
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | CHARLES GRIZZELL
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Credential |
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Telephone | 859-356-3434
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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 | 1474
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1474
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License Number State | KY
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