Provider Demographics
NPI:1194054718
Name:GEORGETOWN TOWNSHIP FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:GEORGETOWN TOWNSHIP FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LT./ MEDICAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-948-0288
Mailing Address - Street 1:5610 CORYDON RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47122-9260
Mailing Address - Country:US
Mailing Address - Phone:812-948-0288
Mailing Address - Fax:812-948-8825
Practice Address - Street 1:5610 CORYDON RIDGE RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:IN
Practice Address - Zip Code:47122-9260
Practice Address - Country:US
Practice Address - Phone:812-948-0288
Practice Address - Fax:812-948-8825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1077341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance