Provider Demographics
NPI:1154867273
Name:WILDERNESS VOLUNTEER FIRE DEPARTMENT INC
Entity type:Organization
Organization Name:WILDERNESS VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BICKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-872-6339
Mailing Address - Street 1:119 E MOUNT LOOKOUT RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LOOKOUT
Mailing Address - State:WV
Mailing Address - Zip Code:26678-9273
Mailing Address - Country:US
Mailing Address - Phone:304-872-6339
Mailing Address - Fax:304-872-7124
Practice Address - Street 1:119 E MOUNT LOOKOUT RD
Practice Address - Street 2:
Practice Address - City:MOUNT LOOKOUT
Practice Address - State:WV
Practice Address - Zip Code:26678-9273
Practice Address - Country:US
Practice Address - Phone:304-872-6339
Practice Address - Fax:304-872-7124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport