Provider Demographics
NPI:1780683219
Name:RED BIRD VOLUNTEER FIRE AND RESCUE INC
Entity Type:Organization
Organization Name:RED BIRD VOLUNTEER FIRE AND RESCUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-598-7744
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 1:31 QUEENDALE CTR
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:KY
Practice Address - Zip Code:40913-9602
Practice Address - Country:US
Practice Address - Phone:606-598-7744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15833416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY080012400OtherBLACK LUNG
KY55026025Medicaid
KY000000070085OtherANTHEM
KY56008097Medicaid
KY55026025Medicaid
KY8046201Medicare PIN