Provider Demographics
NPI:1154414910
Name:CROMWELL VOLUNTEER FIRE DEPARTMENT
Entity type:Organization
Organization Name:CROMWELL VOLUNTEER FIRE DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROXANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROMANOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-384-9534
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:5592 HIGHWAY 210
Mailing Address - City:CROMWELL
Mailing Address - State:MN
Mailing Address - Zip Code:55726
Mailing Address - Country:US
Mailing Address - Phone:218-644-3547
Mailing Address - Fax:
Practice Address - Street 1:5592 HIGHWAY 210
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:MN
Practice Address - Zip Code:55726
Practice Address - Country:US
Practice Address - Phone:218-644-3547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF CROMWELL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00613416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN222067900Medicaid
MN75166CROtherBCBS
MN8181397OtherMEDICA DUAL SOLUTION MSHO
MN122197OtherHEALTH PARTNERS
MN8194782OtherMEDICA
MN172069OtherUCARE
MN599000201Medicare PIN