Provider Demographics
NPI:1689670820
Name:MOUNT PLEASANT VOLUNTEER FIRE DEPARTMENT INC OF JEFFERSON COUNTY
Entity Type:Organization
Organization Name:MOUNT PLEASANT VOLUNTEER FIRE DEPARTMENT INC OF JEFFERSON COUNTY
Other - Org Name:MOUNT PLEASANT VOLUNTEER FIRE DEPT INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PANEPUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-769-7729
Mailing Address - Street 1:PO BOX 6786
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0919
Mailing Address - Country:US
Mailing Address - Phone:304-233-9314
Mailing Address - Fax:304-233-0265
Practice Address - Street 1:198 OAK DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:OH
Practice Address - Zip Code:43939
Practice Address - Country:US
Practice Address - Phone:740-769-7729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2307284Medicaid
OH2307284Medicaid