Provider Demographics
NPI:1194911099
Name:CITY OF FAIRFAX
Entity type:Organization
Organization Name:CITY OF FAIRFAX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-291-2892
Mailing Address - Street 1:PO BOX 5211
Mailing Address - Street 2:DEPT # 116256
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13902-5211
Mailing Address - Country:US
Mailing Address - Phone:703-385-7940
Mailing Address - Fax:703-273-9257
Practice Address - Street 1:4081 UNIVERSITY DR STE 400
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3407
Practice Address - Country:US
Practice Address - Phone:703-385-7940
Practice Address - Fax:703-273-9257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA72341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance