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General NPI Number Information
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NPI Number | 1144354143
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Entity Type | Organization
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Legal Business Name | BRISTOL FIRE DEPT CORP
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 405 E ELKHART ST
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City | BRISTOL
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State | IN
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Zip | 46507-9206
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Country | US
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Telephone | 574-848-4155
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Fax | 574-848-0459
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Provider Business Mailing Address
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Address Line | 405 E ELKHART ST
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City | BRISTOL
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State | IN
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Zip | 46507-9206
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Country | US
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Telephone | 574-848-4155
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Fax | 574-848-0459
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Authorized Official
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Title or Position | ADMINISTRATIVE
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Name | MS. FAY ANN KEMP
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Credential | PARAMEDIC
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Telephone | 574-848-4155
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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 | 0277
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License Number State | IN
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