Provider Demographics
NPI:1174677306
Name:KIDRON VOLUNTEER FIRE DEPARTMENT INC
Entity Type:Organization
Organization Name:KIDRON VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:KIDRON VFD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARMYN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-857-2101
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:KIDRON
Mailing Address - State:OH
Mailing Address - Zip Code:44636-0155
Mailing Address - Country:US
Mailing Address - Phone:330-857-2101
Mailing Address - Fax:
Practice Address - Street 1:4772 KIDRON ROAD
Practice Address - Street 2:
Practice Address - City:KIDRON
Practice Address - State:OH
Practice Address - Zip Code:44636-0155
Practice Address - Country:US
Practice Address - Phone:330-857-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIDRON VOLUNTEER FIRE DEPARTMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-23
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020978850341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH020978850OtherBOARD OF PHARMACY
OH2804184Medicaid
OH2804184Medicaid
OH=========00OtherBWC