1679968622 NPI number — WAYNE TOWNSHIP TRUSTEES TUSCARAWAS COUNTY

Table of content: (NPI 1679968622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679968622 NPI number — WAYNE TOWNSHIP TRUSTEES TUSCARAWAS COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WAYNE TOWNSHIP TRUSTEES TUSCARAWAS COUNTY
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:
WAYNE TWP VOLUNTEER FIRE DEPARTMENT
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:
1679968622
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 126
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUNDEE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44624-0126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-852-2835
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7899 CHERRY RUN ROAD NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNDEE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-602-5180
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2015

Additional Information

Authorized Official

Authorized Official Last Name:
TROYER
Authorized Official First Name:
LISA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
FISCAL OFFICER
Authorized Official Telephone Number:
330-852-2835

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: 021002950 . This is a "STATE OF OHIO PHARMACY LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0139565 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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