Provider Demographics
NPI:1801071584
Name:WALNUT TOWNSHIP VOLUNTEER FIRE DEPTARTMENT, INCORPORATED
Entity type:Organization
Organization Name:WALNUT TOWNSHIP VOLUNTEER FIRE DEPTARTMENT, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-723-1160
Mailing Address - Street 1:PO BOX 241
Mailing Address - Street 2:
Mailing Address - City:NEW ROSS
Mailing Address - State:IN
Mailing Address - Zip Code:47968-0241
Mailing Address - Country:US
Mailing Address - Phone:765-723-2289
Mailing Address - Fax:
Practice Address - Street 1:105 E. STATE STREET
Practice Address - Street 2:
Practice Address - City:NEW ROSS
Practice Address - State:IN
Practice Address - Zip Code:47968
Practice Address - Country:US
Practice Address - Phone:765-723-2289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport