1164499265 NPI number — MIDDLETON TOWNSHIP TRUSTEES

Table of content: (NPI 1164499265)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164499265 NPI number — MIDDLETON TOWNSHIP TRUSTEES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDDLETON TOWNSHIP TRUSTEES
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:
MIDDLETON TOWNSHIP AMBULANCE MIDDLETON TOWNSHIP EMS
Provider Other Organization Name Type Code:
3
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:
1164499265
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
114 SUGAR ST
Provider Second Line Business Mailing Address:
PO BOX 206
Provider Business Mailing Address City Name:
HASKINS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43525-0206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-823-1480
Provider Business Mailing Address Fax Number:
419-823-1377

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
114 SUGAR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HASKINS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43525-0206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-823-1480
Provider Business Practice Location Address Fax Number:
419-823-1377
Provider Enumeration Date:
03/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LIMES
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
FISCAL OFFICER
Authorized Official Telephone Number:
419-823-1480

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0993877 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590009722 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 632443 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080003200 . This is a "FEDERAL BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000156084 . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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