Provider Demographics
NPI:1417997933
Name:BOONE COUNTY FIRE
Entity Type:Organization
Organization Name:BOONE COUNTY FIRE
Other - Org Name:WORTH TOWNSHIP
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-769-5714
Mailing Address - Street 1:2965 S 575 E
Mailing Address - Street 2:P.O.BOX 66
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-9438
Mailing Address - Country:US
Mailing Address - Phone:317-769-3300
Mailing Address - Fax:317-769-3304
Practice Address - Street 1:2965 S 575 E
Practice Address - Street 2:
Practice Address - City:WHITESTOWN
Practice Address - State:IN
Practice Address - Zip Code:46075-9438
Practice Address - Country:US
Practice Address - Phone:317-769-3300
Practice Address - Fax:317-769-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0801341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
INPENDINGMedicaid
INPENDINGMedicaid