Sandy Creek Joint Fire District
Organization Active NPI Ambulance · Minerva, OH
NPI 1700143542 · NPPES record last updated Nov 9, 2022
Key facts
- NPI
- 1700143542
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 022198100 (OH)
- Legal business name
- SANDY CREEK JOINT FIRE DISTRICT
- Practice address
- 505 E Lincolnway
Minerva, OH 44657-2007 - Phone
- (330) 868-5193
- Fax
- (330) 868-5193
- NPI assigned
- Apr 18, 2012
- Organization subpart
- No
Authorized official
- Name
- Aaron C Stoller
- Title
- Chief
- Phone
- (330) 868-5193
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120718000610 | OH | Part B Supplier - Ambulance Service Supplier | 7416113584 | Practice locations: Minerva, OH |
National Provider Directory
Locations
505 E Lincolnway
Minerva, OH 44657
Phone (330) 868-5193
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 022198100 | OH | Yes |
Addresses
Primary practice location
505 E Lincolnway
Minerva, OH 44657-2007
Mailing address
505 E Lincolnway
Minerva, OH 44657-2007
Phone (330) 868-5193
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0071039 | Medicaid | OH | |
| 022198100 | Other | OH | PHARMACY |
Other providers in Minerva, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 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.