Provider Demographics
NPI:1083744700
Name:THE PERRYSVILLE FIRE DEPARTMENT
Entity Type:Organization
Organization Name:THE PERRYSVILLE FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-938-5822
Mailing Address - Street 1:181 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PERRYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44864-9569
Mailing Address - Country:US
Mailing Address - Phone:419-938-5822
Mailing Address - Fax:419-938-8300
Practice Address - Street 1:181 E 3RD ST
Practice Address - Street 2:
Practice Address - City:PERRYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44864-9569
Practice Address - Country:US
Practice Address - Phone:419-938-5822
Practice Address - Fax:419-938-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance