MEDICARE: FAIRVIEW VOLUNTEER FIRE DEPARTMENT INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	1035	NC

General Provider Information

NPI Number	:	1194141325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRVIEW VOLUNTEER FIRE DEPARTMENT INC

Provider Business Mailing Address
First Line	:	PO BOX 244
Second Line	:
City	:	FAIRVIEW
State	:	NC
Zip	:	28730-0244
Country	:	US
Telephone Number	:	828-628-2001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1586 CHARLOTTE HWY
Second Line	:
City	:	FAIRVIEW
State	:	NC
Zip	:	28730-0000
Country	:	US
Telephone Number	:	828-628-2001
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	SCOTT JONES
Credential	:
Telephone Number	:	828-628-2001

Provider Enumeration Date	:	03/12/2014
Last Update Date	:	03/12/2014

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