Provider Demographics
NPI:1518027358
Name:GLENCOE VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:GLENCOE VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PROGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-671-3056
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:OH
Mailing Address - Zip Code:43928-0232
Mailing Address - Country:US
Mailing Address - Phone:740-671-9800
Mailing Address - Fax:
Practice Address - Street 1:50083 2ND STREET
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:OH
Practice Address - Zip Code:43928-0232
Practice Address - Country:US
Practice Address - Phone:740-671-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2434379Medicaid
OH2434379Medicaid
OH2434379Medicaid