Provider Demographics
NPI:1942261847
Name:FRIES VOLUNTEER FIRE DEPARTMENT INC
Entity Type:Organization
Organization Name:FRIES VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-744-2111
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:FRIES
Mailing Address - State:VA
Mailing Address - Zip Code:24330-0009
Mailing Address - Country:US
Mailing Address - Phone:276-744-2141
Mailing Address - Fax:276-744-2111
Practice Address - Street 1:832 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:FRIES
Practice Address - State:VA
Practice Address - Zip Code:24330-0009
Practice Address - Country:US
Practice Address - Phone:276-744-2141
Practice Address - Fax:276-744-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-30
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA389341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190001402Medicare ID - Type Unspecified
VA190001402Medicare UPIN