Organization
GOODSON KINDERHOOK VOLUNTEER FIRE DEPARTMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDRICK C. LEWIS (TREASURER)
(276) 669-1251
Entity
Organization
Contact information
Practice address
19864 BENHAMS RD, BRISTOL, VA 24202-2800
(276) 669-1251
(270) 984-1537
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
00854
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010106991
—
VA
01
—
P00149307
RAILROAD MEDICARE
—
Enumeration date
07/09/2006
Last updated
08/09/2023
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