# FAYETTEVILLE FIRE DEPARTMENT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548684210
- **Authorized official:** JENNIFER A ROSSELOT (ASST. TREASURER)
- **Authorized official phone:** (513) 875-3824

## Contact information

- **Practice address:** 100 N. APPLE ST., FAYETTEVILLE, OH 45118
- **Practice address phone:** (513) 875-2202
- **Mailing address:** PO BOX 392907, PITTSBURGH, PA 15251-9907
- **Mailing address phone:** (800) 962-1484
- **Mailing address fax:** (513) 772-4464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 020427852 | OH | Yes |

## Other

- **Enumeration date:** 02/14/2014
- **Last updated:** 05/14/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000007951 | ANTHEM | — |
| 05 | — | 0102894 | — | OH |