Provider Demographics
NPI:1851382659
Name:GREGG TOWNSHIP VOLUNTEER FIRE DEPARTMENT INC
Entity Type:Organization
Organization Name:GREGG TOWNSHIP VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-342-8814
Mailing Address - Street 1:6249 N BALTIMORE RD
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:IN
Mailing Address - Zip Code:46157-9188
Mailing Address - Country:US
Mailing Address - Phone:765-342-8814
Mailing Address - Fax:765-349-1566
Practice Address - Street 1:6249 N BALTIMORE RD
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:IN
Practice Address - Zip Code:46157-9188
Practice Address - Country:US
Practice Address - Phone:765-342-8814
Practice Address - Fax:765-349-1566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN986800Medicare PIN