Provider Demographics
NPI:1942873195
Name:OTTERBEIN VOLUNTEER FIREFIGHTER INC
Entity Type:Organization
Organization Name:OTTERBEIN VOLUNTEER FIREFIGHTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:CORDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-237-4185
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:OTTERBEIN
Mailing Address - State:IN
Mailing Address - Zip Code:47970-0577
Mailing Address - Country:US
Mailing Address - Phone:765-237-4185
Mailing Address - Fax:
Practice Address - Street 1:7628 S 1150 E
Practice Address - Street 2:
Practice Address - City:OTTERBEIN
Practice Address - State:IN
Practice Address - Zip Code:47970
Practice Address - Country:US
Practice Address - Phone:765-237-4185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance