Provider Demographics
NPI:1629218490
Name:SANTA CLAUS VOL. FIRE DEPT. INC.
Entity Type:Organization
Organization Name:SANTA CLAUS VOL. FIRE DEPT. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAGEDORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-937-2551
Mailing Address - Street 1:90 N HOLIDAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLAUS
Mailing Address - State:IN
Mailing Address - Zip Code:47579-8500
Mailing Address - Country:US
Mailing Address - Phone:812-937-2551
Mailing Address - Fax:812-937-2630
Practice Address - Street 1:90 N HOLIDAY BLVD
Practice Address - Street 2:
Practice Address - City:SANTA CLAUS
Practice Address - State:IN
Practice Address - Zip Code:47579-8500
Practice Address - Country:US
Practice Address - Phone:812-937-2551
Practice Address - Fax:812-937-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN04573416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport