1518186071 NPI number — SALINE TWP TRUSTEES

Table of content: (NPI 1518186071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518186071 NPI number — SALINE TWP TRUSTEES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SALINE TWP 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:
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:
1518186071
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MAIN STREET
Provider Second Line Business Mailing Address:
PO BOX 177
Provider Business Mailing Address City Name:
HAMMONDSVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-532-2195
Provider Business Mailing Address Fax Number:
330-532-5844

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
164 COUNTY ROAD 50A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMMONDVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43930-0177
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-612-3380
Provider Business Practice Location Address Fax Number:
330-532-5844
Provider Enumeration Date:
04/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GOTSCHALL
Authorized Official First Name:
CALEB
Authorized Official Middle Name:
E
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
407-219-0752

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  02-0578050 , 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: ========= . This is a "TRICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2038100 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 34600256 . This is a "MEDMUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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