Kidron Volunteer Fire Department Inc
Organization Active NPI Ambulance · Kidron, OH
NPI 1174677306 · NPPES record last updated Jan 9, 2023
Key facts
- NPI
- 1174677306
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 020978850 (OH)
- Legal business name
- KIDRON VOLUNTEER FIRE DEPARTMENT INC
- Practice address
- 4772 Kidron Road
Kidron, OH 44636-0155 - Phone
- (330) 857-2101
- NPI assigned
- Jan 23, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- KIDRON VOLUNTEER FIRE DEPARTMENT INC
Authorized official
- Name
- Karmyn D Knox
- Title
- EMS Billing Coordinator
- Phone
- (330) 857-2101
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D1075530 | Kidron Volunteer Fire Department | Certificate of waiver | Oct 22, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071024000453 | OH | Part B Supplier - Ambulance Service Supplier | 4486741394 | Practice locations: Kidron, OH |
National Provider Directory
- Part of
- Kidron Volunteer Fire Department Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 020978850 | OH | Yes |
Addresses
Primary practice location
4772 Kidron Road
Kidron, OH 44636-0155
Mailing address
PO Box 155
Kidron, OH 44636-0155
Phone (330) 857-2101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020978850 | Other | OH | BOARD OF PHARMACY |
| 2804184 | Medicaid | OH |
Other names
- Kidron VFD
Other providers in Kidron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.