Provider Demographics
NPI:1932438819
Name:MADISON TOWNSHIP FIRE AND RESCUE
Entity Type:Organization
Organization Name:MADISON TOWNSHIP FIRE AND RESCUE
Other - Org Name:MADISON TOWNSHIP VOLUNTEER FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:W
Authorized Official - Last Name:HARSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-339-4861
Mailing Address - Street 1:P O BOX 81
Mailing Address - Street 2:302 EAST WATER STREET
Mailing Address - City:LINDEN
Mailing Address - State:IN
Mailing Address - Zip Code:47955-0081
Mailing Address - Country:US
Mailing Address - Phone:765-339-4861
Mailing Address - Fax:765-339-4859
Practice Address - Street 1:302 EAST WATER STREET
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:IN
Practice Address - Zip Code:47955-0081
Practice Address - Country:US
Practice Address - Phone:765-339-4861
Practice Address - Fax:765-339-4859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1063146N00000X
IN343900000X251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
No251V00000XAgenciesVoluntary or CharitableGroup - Single Specialty