Provider Demographics
NPI:1114167749
Name:SCHNELLVILLE VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:SCHNELLVILLE VOLUNTEER FIRE DEPARTMENT
Other - Org Name:SCHNELLVILLE FIREFGHTING CORPORATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-630-0175
Mailing Address - Street 1:8090 E SCHNELLVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SCHNELLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47580-9701
Mailing Address - Country:US
Mailing Address - Phone:812-630-0175
Mailing Address - Fax:
Practice Address - Street 1:8090 E SCHNELLVILLE RD
Practice Address - Street 2:
Practice Address - City:SCHNELLVILLE
Practice Address - State:IN
Practice Address - Zip Code:47580-9701
Practice Address - Country:US
Practice Address - Phone:812-630-0175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-22
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0467343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0467OtherINDIANA EMS COMMISSION