Port William-Liberty Township Joint Fire and EMS District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS020327100 Issued in OH

Legal business name

PORT WILLIAM-LIBERTY TOWNSHIP JOINT FIRE AND EMS DISTRICT

Doing business as

Port William Life Squad

Practice address

7211 North Street RT. 134
Wilmington, OH 45177-9629

Phone

(937) 414-0085

Fax

(937) 486-5300

NPI assigned

Sep 9, 2013

Last updated

Dec 17, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ronald Stryker

Title

Director

Phone

(937) 414-0085

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Port William Life Squad Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1144655283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 NORTH STREET RT. 134",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451779629",
            "telephone_number": "937-414-0085",
            "fax_number": "937-486-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT WILLIAM-LIBERTY TOWNSHIP JOINT FIRE AND EMS DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "STRYKER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "937-414-0085"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "EMS020327100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL - FECA /BL / ENERGY",
            "identifier": "710731700",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157115",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port William Life Squad",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Port William Life Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darlene J Pitzer
• Jesse Holt Pohly, PA-C
• Laura Poindexter
• Antonio Christopher Poma
• Emily Megan Poppaw
• Mahyar Pourriahi, M.D.
• Aaron C Powell
• Premier Health Care LLC
• Premier Health Care LLC (Premier Urgent Care Of Wilmington)
• Benjamin Lewis Prewitt, PHARM D. RPH

• Land Ambulance in Wilmington, OH
• Providers in Wilmington, OH by specialty
• Land Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.