Paxton Township Ttees

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

020323250 Issued in OH

Legal business name

PAXTON TOWNSHIP TTEES

Doing business as

Paxton Township Area Life Squad

Practice address

202 S Mountain St
Bainbridge, OH 45612-1135

Phone

(740) 634-3307

NPI assigned

Aug 18, 2005

Organization subpart

No

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

Authorized official

Name

Vicky Mettler

Title

Fiscal Officer

Phone

(740) 634-3241

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Paxton Township Area Life Squad Doing business as

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1194717835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10361 SPARTAN DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452151220",
            "telephone_number": "800-962-1484",
            "fax_number": "513-772-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S MOUNTAIN ST",
            "city": "BAINBRIDGE",
            "state": "OH",
            "postal_code": "456121135",
            "telephone_number": "740-634-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAXTON TOWNSHIP TTEES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "METTLER",
        "authorized_official_first_name": "VICKY",
        "authorized_official_title_or_position": "FISCAL OFFICER",
        "authorized_official_telephone_number": "740-634-3241"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "020323250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2435225",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00121690",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000297651",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paxton Township Area Life Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Orr, CDCA,QMHS
• Paint Valley Local School District
• Charles Adam Pate
• Rebecca Lynn Pate
• Shelby Lynn Patrick, M. ED, LPCC
• Loretta Mae Penwell, LPN
• Paul Penwell, CDCA, QMHS
• April Peters, LPN
• Premise Health of Ohio Medical PA (Scioto Advantage - Bainbridge)
• Janet Priest

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.