Provider Demographics
NPI:1912074303
Name:EAST SPRINGFIELD VOLUNTEER FIRE DEPARTMENT
Entity type:Organization
Organization Name:EAST SPRINGFIELD VOLUNTEER FIRE DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:J
Authorized Official - Last Name:YOHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-543-4047
Mailing Address - Street 1:836 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1407
Mailing Address - Country:US
Mailing Address - Phone:304-521-1576
Mailing Address - Fax:304-521-1576
Practice Address - Street 1:9845 CR 39
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:OH
Practice Address - Zip Code:43910-9998
Practice Address - Country:US
Practice Address - Phone:740-543-3563
Practice Address - Fax:304-521-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020423250341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherBWC
OH001705085OtherMT STATE
OH0619629Medicaid
OH590004478OtherRAILROAD MEDICARE
OH000000155352OtherBCBS
OH590004478OtherRR MEDICARE
OH=========OtherMED MUTUAL
OH800231OtherBLACK LUNG