Provider Demographics
NPI:1457680688
Name:ROCKPORT OHIO TOWNSHIP FIRE DEPARTMENT
Entity Type:Organization
Organization Name:ROCKPORT OHIO TOWNSHIP FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:AHL
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:812-649-4654
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:IN
Mailing Address - Zip Code:47635-0133
Mailing Address - Country:US
Mailing Address - Phone:812-649-4654
Mailing Address - Fax:
Practice Address - Street 1:615 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:IN
Practice Address - Zip Code:47635-0133
Practice Address - Country:US
Practice Address - Phone:812-649-4654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)