Brilliant Volunteer Fire Department Inc

Organization Active NPI Ambulance · Brilliant, OH

NPI 1215026547 · NPPES record last updated Mar 28, 2022

Key facts

NPI
1215026547
Entity type
Organization (NPI type 2)
Primary specialty
Ambulance 341600000X
License
02-0313750 (OH)
Legal business name
BRILLIANT VOLUNTEER FIRE DEPARTMENT INC
Practice address
1001 Third Street
Brilliant, OH 43913-1209
Phone
(740) 598-4151
Fax
(740) 598-4153
NPI assigned
Oct 12, 2006
Organization subpart
No

Authorized official

Name
Mr. Brian A Harvey
Title
Chief
Phone
(740) 598-4151

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050610000001 OH Part B Supplier - Ambulance Service Supplier 2163465139 Practice locations: Brilliant, OH

National Provider Directory

Locations

1001 3rd St
Brilliant, OH 43913
Phone (740) 598-4151

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 02-0313750 OH Yes
Ambulance 341600000X

Addresses

Primary practice location

1001 Third Street
Brilliant, OH 43913-1209

Mailing address

1001 Third Street
Brilliant, OH 43913-1209
Phone (740) 598-4151

Other identifiers

IdentifierTypeStateIssuer
0478773MedicaidOH
3453126000OtherOHBWC
590000629OtherOHRRMEDICARE
000000156086OtherOHBCBS

Other providers in Brilliant, OH

All providers in Brilliant, OH · Ambulance in Ohio

Sources for this page

Verify at the official NPI Registry.