1104197722 NPI number — ORANGE TOWNSHIP FIRE DEPARTMENT INC

Table of content: (NPI 1104197722)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104197722 NPI number — ORANGE TOWNSHIP FIRE DEPARTMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORANGE TOWNSHIP FIRE DEPARTMENT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104197722
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 123
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NANKIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44848-0123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-289-6866
Provider Business Mailing Address Fax Number:
419-496-0052

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 STATE ROUTE 302
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NANKIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-289-6866
Provider Business Practice Location Address Fax Number:
419-496-0052
Provider Enumeration Date:
01/13/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MCCONNELL
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
419-289-6866

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 022150850 . This is a "BOARD OF PHARMACY" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0102446 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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