Organization
KENTON COMMUNITY VOLUTNEER FIRE DEPARTMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES GRIZZELL (FIRE CHIEF)
(859) 356-3434
Entity
Organization
Contact information
Practice address
14081 DECOURSEY PIKE, KENTON, KY 41063
(859) 356-3434
Mailing address
10361 SPARTAN DR, CINCINNATI, OH 45215-1220
(800) 962-1484
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
1474
KY
3416L0300X
Land Ambulance
Primary
1474
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000378825
ANTHEM
KY
05
—
0328103
—
OH
01
—
3110021370
WV WORKERS COMP
WV
05
—
55001416
—
KY
05
—
56031388
—
KY
01
—
P00657887
RAILROAD MEDICARE
KY
Enumeration date
07/12/2005
Last updated
05/04/2017
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