Provider Demographics
NPI:1215639679
Name:PORT GIBSON VOLUNTEER FIRE DEPARTMENT INC
Entity type:Organization
Organization Name:PORT GIBSON VOLUNTEER FIRE DEPARTMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-277-0700
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:PORT GIBSON
Mailing Address - State:NY
Mailing Address - Zip Code:14537-0115
Mailing Address - Country:US
Mailing Address - Phone:315-277-0700
Mailing Address - Fax:
Practice Address - Street 1:2939 GREIG ST
Practice Address - Street 2:
Practice Address - City:PORT GIBSON
Practice Address - State:NY
Practice Address - Zip Code:14537-9707
Practice Address - Country:US
Practice Address - Phone:315-331-1028
Practice Address - Fax:315-331-3588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport