Organization
KENTON COMMUNITY VOLUTNEER FIRE DEPARTMENT INC
Active
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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