Provider Demographics
NPI:1811141872
Name:SOUTHERN HIGHLAND JOINT FIRE DISTRICT
Entity type:Organization
Organization Name:SOUTHERN HIGHLAND JOINT FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-402-7356
Mailing Address - Street 1:4750 HEMPSTEAD STATION DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5164
Mailing Address - Country:US
Mailing Address - Phone:888-709-4357
Mailing Address - Fax:937-619-3028
Practice Address - Street 1:50 MAPLE STREET
Practice Address - Street 2:
Practice Address - City:MOWRYSTOWN
Practice Address - State:OH
Practice Address - Zip Code:45155
Practice Address - Country:US
Practice Address - Phone:937-402-7355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000598798OtherANTHEM
OH2958116Medicaid
OH2958116Medicaid