Provider Demographics
NPI:1972625473
Name:TILTONSVILLE VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:TILTONSVILLE VOLUNTEER FIRE DEPARTMENT
Other - Org Name:TILTONSVILLE VFD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-859-2664
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:TILTONSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43963-0032
Mailing Address - Country:US
Mailing Address - Phone:740-859-2664
Mailing Address - Fax:740-859-1100
Practice Address - Street 1:123 B GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:TILTONSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43963-1079
Practice Address - Country:US
Practice Address - Phone:740-859-2664
Practice Address - Fax:740-859-1100
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TILTONSVILLE VOLUNTEER FIRE DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-04
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2179771Medicaid
OH9301701Medicare PIN