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General NPI Number Information
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NPI Number | 1396306288
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Entity Type | Organization
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Legal Business Name | RUSSIAVILLE VOLUNTEER FIRE DEPARTMENT INC.
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Dates
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Enumeration Date | 06/22/2019
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 140 E MAIN ST
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City | RUSSIAVILLE
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State | IN
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Zip | 46979-9121
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Country | US
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Telephone | 765-883-5200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | RUSSIAVILLE
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State | IN
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Zip | 46979-0188
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Country | US
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Telephone | 765-883-5200
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Fax | 765-883-5200
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Authorized Official
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Title or Position | DIRECTOR
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Name | DUSTIN REDDING
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Credential |
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Telephone | 765-883-5200
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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 |
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License Number State |
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