1316939010 NPI number — MORROW COUNTY FIREFIGHTERS & SQUADMENS ASSOCIATION

Table of content: (NPI 1316939010)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316939010 NPI number — MORROW COUNTY FIREFIGHTERS & SQUADMENS ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MORROW COUNTY FIREFIGHTERS & SQUADMENS ASSOCIATION
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:
MORROW COUNTY 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:
1316939010
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
140 S MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT GILEAD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43338-1408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-946-7727
Provider Business Mailing Address Fax Number:
419-946-1601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT GILEAD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43338-1408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-946-7727
Provider Business Practice Location Address Fax Number:
419-946-1601
Provider Enumeration Date:
08/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SPARKS
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS MANAGER
Authorized Official Telephone Number:
419-946-7727

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: 2080724 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000154999 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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