Provider Demographics
NPI:1629157888
Name:BURTON VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:BURTON VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SESTAK
Authorized Official - Suffix:
Authorized Official - Credentials:CHIEF
Authorized Official - Phone:1440-834-4416
Mailing Address - Street 1:13828 SPRING STREET
Mailing Address - Street 2:P. O. BOX 243
Mailing Address - City:BURTON
Mailing Address - State:OH
Mailing Address - Zip Code:44021-0243
Mailing Address - Country:US
Mailing Address - Phone:440-834-4416
Mailing Address - Fax:440-834-0490
Practice Address - Street 1:13828 SPRING ST
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:OH
Practice Address - Zip Code:44021
Practice Address - Country:US
Practice Address - Phone:800-707-6753
Practice Address - Fax:614-890-2947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2482068Medicaid
OH000000187856OtherBLUE CROSS BLUE SHIELD
OH=========00OtherWORKER COMPENSATION
OH2482068Medicaid