Provider Demographics
NPI:1215026547
Name:BRILLIANT VOLUNTEER FIRE DEPARTMENT INC
Entity Type:Organization
Organization Name:BRILLIANT VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-598-4151
Mailing Address - Street 1:1001 THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:BRILLIANT
Mailing Address - State:OH
Mailing Address - Zip Code:43913-1209
Mailing Address - Country:US
Mailing Address - Phone:740-598-4151
Mailing Address - Fax:740-598-4153
Practice Address - Street 1:1001 THIRD STREET
Practice Address - Street 2:
Practice Address - City:BRILLIANT
Practice Address - State:OH
Practice Address - Zip Code:43913-1209
Practice Address - Country:US
Practice Address - Phone:740-598-4151
Practice Address - Fax:740-598-4153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0313750341600000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0478773Medicaid
OH3453126000OtherBWC
OH590000629OtherRRMEDICARE
OH000000156086OtherBCBS
OH3453126000OtherBWC
OH590000629OtherRRMEDICARE