Organization
WOLFHURST CENTRAL VOLUNTEER FIRE DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT S ICE (PRESIDENT)
(740) 635-3192
Entity
Organization
Contact information
Practice address
55485 BRAND AVE, LANSING, OH 43954
(740) 635-3192
Mailing address
55485 BRAND AVE, BRIDGEPORT, OH 43912-1547
(740) 635-3192
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
020324800
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000288061
BCBS
OH
01
—
00074611
RR MEDICARE
OH
05
—
2072000
—
OH
Enumeration date
02/12/2007
Last updated
12/01/2016
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