Fairfield Township
Organization Active NPI Ambulance · Somerdale, OH
NPI 1154482172 · NPPES record last updated May 24, 2022
Key facts
- NPI
- 1154482172
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 020893850 (OH)
- Legal business name
- FAIRFIELD TOWNSHIP
- Practice address
- 6288 Firehouse Street
Somerdale, OH 44678 - Phone
- (330) 859-2311
- NPI assigned
- Dec 13, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- FAIRFIELD TOWNSHIP
Authorized official
- Name
- Jennifer L Brown
- Title
- Fiscal Officer
- Phone
- (330) 343-9711
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070119000252 | OH | Part B Supplier - Ambulance Service Supplier | 4789685686 | Practice locations: Somerdale, OH |
National Provider Directory
- Part of
- Fairfield Township
Locations
5311 Johnstown Rd NE
Mineral City, OH 44656
Phone (330) 343-9711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 020893850 | OH | Yes |
Addresses
Primary practice location
6288 Firehouse Street
Somerdale, OH 44678
Mailing address
5311 Johnstown Rd NE
Mineral City, OH 44656-9046
Phone (330) 343-9711
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000176079 | Other | OH | ANTHEM BCBS |
| 0377542 | Medicaid | OH |
Other names
- Fairfield Township Volunteer Fire Department
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.