Provider Demographics
NPI:1801019112
Name:GASTON VOLUNTEER FIRE DEPT, INC
Entity Type:Organization
Organization Name:GASTON VOLUNTEER FIRE DEPT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-775-6753
Mailing Address - Street 1:PO BOX 56002
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-0002
Mailing Address - Country:US
Mailing Address - Phone:317-849-6628
Mailing Address - Fax:317-849-6632
Practice Address - Street 1:105 N. SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:GASTON
Practice Address - State:IN
Practice Address - Zip Code:47342
Practice Address - Country:US
Practice Address - Phone:765-358-3104
Practice Address - Fax:765-358-3067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0316341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN262410OtherMEDICARE
IN000000111968OtherBCBS
590009468OtherRR MEDICARE