Provider Demographics
NPI:1316098312
Name:COMMUNITY VOLUNTEER FIRE DEPARTMENT OF MAYNARD INC
Entity type:Organization
Organization Name:COMMUNITY VOLUNTEER FIRE DEPARTMENT OF MAYNARD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-699-4929
Mailing Address - Street 1:PO BOX 301
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:OH
Mailing Address - Zip Code:43937-0301
Mailing Address - Country:US
Mailing Address - Phone:740-699-4929
Mailing Address - Fax:
Practice Address - Street 1:50266 FAIRPOINT-MAYNARD ROAD
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:OH
Practice Address - Zip Code:43937
Practice Address - Country:US
Practice Address - Phone:740-699-4929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY VOLUNTEER FIRE DEPARTMENT OF MAYNARD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-16
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000594998OtherBCBS
OH2729159Medicaid
OH34145470400OtherBWC
OHP00716085OtherRR MEDICARE
OH9379911Medicare PIN