Raleigh Fire Department, Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0309 Issued in IN

Legal business name

RALEIGH FIRE DEPARTMENT, INC

Practice address

1744 East 800 North
Rushville, IN 46173-8915

Phone

(765) 645-5041

Fax

(765) 645-5013

NPI assigned

Jul 18, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Verlin Custer

Title

Chief

Phone

(765) 645-5041

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1790784296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 4TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257011407",
            "telephone_number": "800-676-4785",
            "fax_number": "304-522-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 EAST 800 NORTH",
            "city": "RUSHVILLE",
            "state": "IN",
            "postal_code": "461738915",
            "telephone_number": "765-645-5041",
            "fax_number": "765-645-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH FIRE DEPARTMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "CUSTER",
        "authorized_official_first_name": "VERLIN",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "765-645-5041"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000320779",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris Allison Pflum, NP
• Lindsey Poindexter, NP-C
• Emily Price
• Mandy Price, FNP-C
• Marius Racovan, MD
• Tammy L Ralstin
• Mandy Reisman, MSW
• Residential CRF, Inc.
• Residential CRF, Inc.
• Tonia Lynn Richards, MS, LMHC, LCAC

• All providers in Rushville, IN
• Land Ambulance in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.