Provider Demographics
NPI:1174852974
Name:DECATUR FIRE DEPARTMENT
Entity Type:Organization
Organization Name:DECATUR FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIREFIGHTER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:HEYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-724-8909
Mailing Address - Street 1:206 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IN
Mailing Address - Zip Code:46733-1682
Mailing Address - Country:US
Mailing Address - Phone:260-724-8909
Mailing Address - Fax:260-724-8908
Practice Address - Street 1:206 S 7TH ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IN
Practice Address - Zip Code:46733-1682
Practice Address - Country:US
Practice Address - Phone:260-724-8909
Practice Address - Fax:260-724-8908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0854343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)