Provider Demographics
NPI:1982290615
Name:CORDRY-SWEETWATER VOLUNTEER FIRE DEPARTMENT & AMBULANCE CORPS, INC.
Entity Type:Organization
Organization Name:CORDRY-SWEETWATER VOLUNTEER FIRE DEPARTMENT & AMBULANCE CORPS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:LEAVITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-933-2224
Mailing Address - Street 1:101 FIREHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NINEVEH
Mailing Address - State:IN
Mailing Address - Zip Code:46164-9127
Mailing Address - Country:US
Mailing Address - Phone:317-933-2224
Mailing Address - Fax:
Practice Address - Street 1:101 FIREHOUSE RD
Practice Address - Street 2:
Practice Address - City:NINEVEH
Practice Address - State:IN
Practice Address - Zip Code:46164-9127
Practice Address - Country:US
Practice Address - Phone:317-933-2224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport