Organization
SOUTHGATE VOLUNTEER FIRE DEPARTMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY KRAMER (ADMINISTRATOR)
(859) 441-1422
Entity
Organization
Contact information
Practice address
122 ELECTRIC AVE, SOUTHGATE, KY 41071-3166
(859) 441-1422
(859) 781-5598
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(800) 676-4785
(304) 522-4222
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1539
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340543
ANTHEM
KY
05
—
55001093
—
KY
01
—
590009391
RAILROAD MEDICARE
KY
01
—
61607801500
WV WORKERS COMP
WV
Enumeration date
07/19/2005
Last updated
09/09/2011
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