Provider Demographics
NPI:1992846125
Name:CENTRAL CITY FIRE DEPARTMENT
Entity Type:Organization
Organization Name:CENTRAL CITY FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:RUSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:814-754-5111
Mailing Address - Street 1:241 SUNSHINE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15926-1164
Mailing Address - Country:US
Mailing Address - Phone:814-754-5111
Mailing Address - Fax:
Practice Address - Street 1:241 SUNSHINE AVE
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:PA
Practice Address - Zip Code:15926-1164
Practice Address - Country:US
Practice Address - Phone:814-754-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA5630907146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty