Provider Demographics
NPI:1386642288
Name:CARTHAGE VOLUNTEER FIRE DEPARTMENT OF RUSH COUNTY INC
Entity Type:Organization
Organization Name:CARTHAGE VOLUNTEER FIRE DEPARTMENT OF RUSH COUNTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-565-1234
Mailing Address - Street 1:836 4TH AVE.
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701
Mailing Address - Country:US
Mailing Address - Phone:800-676-4785
Mailing Address - Fax:304-522-4222
Practice Address - Street 1:208 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:IN
Practice Address - Zip Code:46115-9629
Practice Address - Country:US
Practice Address - Phone:765-565-1234
Practice Address - Fax:765-565-6433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN387341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000214149OtherANTHEM
IN590015637OtherRAILROAD MEDICARE
IN200239270AMedicaid
IN590015637OtherRAILROAD MEDICARE
KY000000214149OtherANTHEM
IN162000Medicare PIN