Provider Demographics
NPI:1871657551
Name:ST. JOHNS VOLUNTEER FIRE & RESCUE DEPARTMENT INC.
Entity Type:Organization
Organization Name:ST. JOHNS VOLUNTEER FIRE & RESCUE DEPARTMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:419-568-3988
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:13860 WALNUT STREET
Mailing Address - City:SAINT JOHNS
Mailing Address - State:OH
Mailing Address - Zip Code:45884-0194
Mailing Address - Country:US
Mailing Address - Phone:419-738-7638
Mailing Address - Fax:
Practice Address - Street 1:13860 WALNUT STREET
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:OH
Practice Address - Zip Code:45884-0194
Practice Address - Country:US
Practice Address - Phone:419-738-7638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH146L00000X, 146M00000X, 3416L0300X
146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9283181Medicare PIN