Provider Demographics
NPI:1588663348
Name:CUMBERLAND RIVER VOLUNTEER FIRE DEPARTMENT INC
Entity Type:Organization
Organization Name:CUMBERLAND RIVER VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-589-5930
Mailing Address - Street 1:836 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13279 HWY 119 SOUTH
Practice Address - Street 2:
Practice Address - City:PARTRIDGE
Practice Address - State:KY
Practice Address - Zip Code:40862-6417
Practice Address - Country:US
Practice Address - Phone:606-589-5930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1635341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY080029500OtherBLACK LUNG
KY590012920OtherRAILROAD MEDICARE
WV1064293OtherWV WORKERS COMP
KY000000070178OtherANTHEM
KY50008634OtherPASSPORT
KY55067078Medicaid
KY56008253Medicaid
KY50008634OtherPASSPORT
KY590012920OtherRAILROAD MEDICARE
KY000000070178OtherANTHEM