Provider Demographics
NPI:1255339164
Name:CUTSHIN VOLUNTEER FIRE & RESCUE
Entity type:Organization
Organization Name:CUTSHIN VOLUNTEER FIRE & RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-279-4125
Mailing Address - Street 1:836 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1407
Mailing Address - Country:US
Mailing Address - Phone:800-676-4785
Mailing Address - Fax:304-522-4222
Practice Address - Street 1:100 W RESCUE LANE
Practice Address - Street 2:
Practice Address - City:YEADDISS
Practice Address - State:KY
Practice Address - Zip Code:41777-8637
Practice Address - Country:US
Practice Address - Phone:606-279-4125
Practice Address - Fax:606-279-4125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1620341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000070112OtherANTHEM
KY590012383OtherRAILROAD MEDICARE
KY56008220Medicaid
KY55066054Medicaid
KY081068100OtherBLACK LUNG
KY=========OtherTRICARE
KY55066054Medicaid
KY=========OtherTRICARE