Provider Demographics
NPI:1619640604
Name:INDIAN HEAD VOLUNTEER FIRE DEPT AND RESCUE SQUAD, INC.
Entity Type:Organization
Organization Name:INDIAN HEAD VOLUNTEER FIRE DEPT AND RESCUE SQUAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-479-4790
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-0535
Mailing Address - Country:US
Mailing Address - Phone:410-479-4790
Mailing Address - Fax:
Practice Address - Street 1:4095 INDIAN HEAD HWY
Practice Address - Street 2:
Practice Address - City:INDIAN HEAD
Practice Address - State:MD
Practice Address - Zip Code:20640-1781
Practice Address - Country:US
Practice Address - Phone:301-743-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport