Provider Demographics
NPI:1598906182
Name:COAL CREEK FIRE & RESCUE INC.
Entity Type:Organization
Organization Name:COAL CREEK FIRE & RESCUE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-275-2645
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47967-0009
Mailing Address - Country:US
Mailing Address - Phone:765-275-2645
Mailing Address - Fax:765-275-2645
Practice Address - Street 1:215 S PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47967
Practice Address - Country:US
Practice Address - Phone:765-275-2645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty