Provider Demographics
NPI:1487983391
Name:SOUTHEAST TOWNSHIP (ORANGE COUNTY) VOLUNTEER FIRE COMPANY IN
Entity type:Organization
Organization Name:SOUTHEAST TOWNSHIP (ORANGE COUNTY) VOLUNTEER FIRE COMPANY IN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:812-365-2843
Mailing Address - Street 1:PO BOX 376
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:IN
Mailing Address - Zip Code:47454-0376
Mailing Address - Country:US
Mailing Address - Phone:812-723-4166
Mailing Address - Fax:812-723-4166
Practice Address - Street 1:2723 EAST COUNTY ROAD 725SOUTH.
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:IN
Practice Address - Zip Code:47454
Practice Address - Country:US
Practice Address - Phone:812-723-4166
Practice Address - Fax:812-723-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)