Provider Demographics
NPI:1922105667
Name:WINTERSVILLE VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:WINTERSVILLE VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVILACQUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-264-4811
Mailing Address - Street 1:PO BOX 2448
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-0448
Mailing Address - Country:US
Mailing Address - Phone:740-264-4811
Mailing Address - Fax:740-264-7700
Practice Address - Street 1:286 LURAY DR
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3973
Practice Address - Country:US
Practice Address - Phone:740-264-4811
Practice Address - Fax:740-264-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0411647Medicaid
OH000000156151OtherBCBS
OH=========00OtherBWC
OH000000156151OtherBCBS
OH0411647Medicaid
OH=========00OtherBWC