Fort Morrow Fire Department

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

020375200 Issued in OH

Legal business name

FORT MORROW FIRE DEPARTMENT

Practice address

306 North Marion Street
Waldo, OH 43356

Phone

(740) 726-2830

NPI assigned

May 23, 2006

Last updated

Dec 17, 2024By 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

Ryan Mitchell

Title

Chief

Phone

(740) 225-3539

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1609821131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392907",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519907",
            "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": "306 NORTH MARION STREET",
            "city": "WALDO",
            "state": "OH",
            "postal_code": "43356",
            "telephone_number": "740-726-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT MORROW FIRE DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "740-225-3539"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "020375200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2704247",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000392522",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Deprey
• Julia E. Dessert
• Bret Green
• Scott Salyer
• Andrea Marie Schofield, LPN WITH IV CERT
• Katherine Charlie Smith

• Land Ambulance in Waldo, OH
• Providers in Waldo, 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, 2024; 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.