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General NPI Number Information
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NPI Number | 1699791020
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Entity Type | Organization
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Legal Business Name | CLEVELAND TOWNSHIP VOLUNTEER FIRE DEPARTMENT INC
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 29515 COUNTY ROAD 6
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City | ELKHART
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State | IN
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Zip | 46514-9513
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Country | US
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Telephone | 574-264-5443
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Fax | 574-206-9483
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Provider Business Mailing Address
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Address Line | 29515 COUNTY ROAD 6
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City | ELKHART
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State | IN
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Zip | 46514-9513
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Country | US
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Telephone | 574-264-5443
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Fax | 574-206-9483
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Authorized Official
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Title or Position | ASSISTANT CHIEF/TREASURER
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Name | JAMES S PRENTKOWSKI
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Credential |
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Telephone | 574-264-5443
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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 | 1004
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License Number State | IN
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