Provider Demographics
NPI:1598902306
Name:DEFIANCE VOLUNTEER FIRE AND RESCUE
Entity Type:Organization
Organization Name:DEFIANCE VOLUNTEER FIRE AND RESCUE
Other - Org Name:DEFIANCE FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESCUE CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:WILWERDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-572-4019
Mailing Address - Street 1:PO BOX 294
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:IA
Mailing Address - Zip Code:51527
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:402-965-8594
Practice Address - Street 1:205 3RD AVE
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:IA
Practice Address - Zip Code:51527-3061
Practice Address - Country:US
Practice Address - Phone:402-572-4019
Practice Address - Fax:402-965-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA28310003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport