Provider Demographics
NPI:1174737050
Name:LAFFERTY VOLUNTEER FIRE DEPARTMENT INC
Entity type:Organization
Organization Name:LAFFERTY VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SQUAD CAPT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZALESNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-968-3016
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:LAFFERTY
Mailing Address - State:OH
Mailing Address - Zip Code:43951-0146
Mailing Address - Country:US
Mailing Address - Phone:740-968-3016
Mailing Address - Fax:
Practice Address - Street 1:70191 IRWIN STREET
Practice Address - Street 2:
Practice Address - City:LAFFERTY
Practice Address - State:OH
Practice Address - Zip Code:43951
Practice Address - Country:US
Practice Address - Phone:740-968-3016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020326350341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000214695OtherMT. STATE
OH020326350OtherBOARD OF PHARMACY
OH2279949Medicaid
OH000000329805OtherBCBS
OH2279949Medicaid
OH000214695OtherMT. STATE