Provider Demographics
NPI:1659379550
Name:ALEXANDRIA FIRE DISTRICT
Entity Type:Organization
Organization Name:ALEXANDRIA FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CICCARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-635-5991
Mailing Address - Street 1:836 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1407
Mailing Address - Country:US
Mailing Address - Phone:800-676-4785
Mailing Address - Fax:304-522-4222
Practice Address - Street 1:7951 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001-1159
Practice Address - Country:US
Practice Address - Phone:859-635-5991
Practice Address - Fax:859-635-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1558341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000192807OtherANTHEM
OH0973497Medicaid
KY55000277Medicaid
KY50013570OtherPASSPORT
KY56016744Medicaid
KY2822889000OtherPASSPORT ADVANTAGE
KY=========OtherUMWA
KY=========OtherTRICARE
OH=========00OtherOH WORKERS COMP
KY=========OtherUMWA