Provider Demographics
NPI:1205836368
Name:COVINGTON FIRE & RESCUE INC
Entity Type:Organization
Organization Name:COVINGTON FIRE & RESCUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:WEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-473-2101
Mailing Address - Street 1:801 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45318-1752
Mailing Address - Country:US
Mailing Address - Phone:866-631-4452
Mailing Address - Fax:937-291-2971
Practice Address - Street 1:801 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:OH
Practice Address - Zip Code:45318-1752
Practice Address - Country:US
Practice Address - Phone:937-473-2905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02118145113341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000006076OtherANTHEM
OH2170921Medicaid
OH590013773OtherRAILROAD MEDICARE
OH590013773OtherRAILROAD MEDICARE