Provider Demographics
NPI:1104681113
Name:PONDER VOLUNTEER FIRE DEPARTMENT, INC.
Entity type:Organization
Organization Name:PONDER VOLUNTEER FIRE DEPARTMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:LONGBRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-479-2488
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:PONDER
Mailing Address - State:TX
Mailing Address - Zip Code:76259-0386
Mailing Address - Country:US
Mailing Address - Phone:940-479-2488
Mailing Address - Fax:940-479-9271
Practice Address - Street 1:102 E BAILEY ST
Practice Address - Street 2:
Practice Address - City:PONDER
Practice Address - State:TX
Practice Address - Zip Code:76259-7503
Practice Address - Country:US
Practice Address - Phone:940-479-2488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance