Provider Demographics
NPI:1427032580
Name:FOLSOM VOLUNTEER FIRE DEPARTMENT, INC
Entity Type:Organization
Organization Name:FOLSOM VOLUNTEER FIRE DEPARTMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING CLERK/TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:K
Authorized Official - Last Name:GLASSCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:304-334-5782
Mailing Address - Street 1:28372 SHORTLINE HWY.
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:WV
Mailing Address - Zip Code:26348
Mailing Address - Country:US
Mailing Address - Phone:304-334-5782
Mailing Address - Fax:304-334-6992
Practice Address - Street 1:28372 SHORTLINE HWY.
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:WV
Practice Address - Zip Code:26348
Practice Address - Country:US
Practice Address - Phone:304-334-5782
Practice Address - Fax:304-334-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV EMS3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810000986Medicaid
WV080060800OtherBLACK LUNG
OH2602535Medicaid
WV1065538OtherWV WORKERS COMP
WVP00290422OtherRAILROAD MEDICARE
WV001705485OtherBLUE CROSS
WV00290422OtherRAILROAD MEDICARE
OH2602535Medicaid
WV9347771Medicare PIN