Provider Demographics
NPI:1891868139
Name:ALBERTA VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:ALBERTA VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-949-7541
Mailing Address - Street 1:PO BOX 9150
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-9150
Mailing Address - Country:US
Mailing Address - Phone:270-744-9600
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:49 MAIN ST.
Practice Address - Street 2:
Practice Address - City:ALBERTA
Practice Address - State:VA
Practice Address - Zip Code:23821
Practice Address - Country:US
Practice Address - Phone:434-949-7541
Practice Address - Fax:434-949-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA299412OtherANTHEM
VAP00604746OtherRAILROAD MEDICARE
VA010385008Medicaid
VA010385008Medicaid