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Organization

FAYETTEVILLE FIRE DEPARTMENT, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER A ROSSELOT (ASST. TREASURER)
(513) 875-3824
Entity
Organization

Contact information

Practice address
100 N. APPLE ST., FAYETTEVILLE, OH 45118
(513) 875-2202
Mailing address
PO BOX 392907, PITTSBURGH, PA 15251-9907
(800) 962-1484
(513) 772-4464

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
020427852
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000007951
ANTHEM
05
0102894
OH
Enumeration date
02/14/2014
Last updated
05/14/2024
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