Provider Demographics
NPI:1114996196
Name:RYLAND HEIGHTS AND COMMUNITY VOLUNTEER FIRE DEPT INC
Entity Type:Organization
Organization Name:RYLAND HEIGHTS AND COMMUNITY VOLUNTEER FIRE DEPT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SQUAD CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-356-7970
Mailing Address - Street 1:836 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1407
Mailing Address - Country:US
Mailing Address - Phone:304-522-7533
Mailing Address - Fax:304-522-4222
Practice Address - Street 1:10041 DECOURSEY PIKE
Practice Address - Street 2:
Practice Address - City:RYLAND HEIGHTS
Practice Address - State:KY
Practice Address - Zip Code:41015
Practice Address - Country:US
Practice Address - Phone:859-356-7970
Practice Address - Fax:859-356-7970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1305341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000187253OtherANTHEM
KY55059067Medicaid
KY55059067Medicaid