Sullivan Township Board of Trustees
Organization Active NPI Ambulance · Sullivan, OH
NPI 1992732960 · NPPES record last updated May 15, 2024
Key facts
- NPI
- 1992732960
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 021434800 (OH)
- Legal business name
- SULLIVAN TOWNSHIP BOARD OF TRUSTEES
- Practice address
- 500 US Highway 224
Sullivan, OH 44880-9771 - Phone
- (419) 736-2255
- Fax
- (419) 736-2266
- NPI assigned
- Jun 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Douglas W Campbell
- Title
- Chief
- Phone
- (419) 736-2255
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050119000405 | OH | Part B Supplier - Ambulance Service Supplier | 0840249603 | Practice locations: Sullivan, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 021434800 | OH | Yes |
Addresses
Primary practice location
500 US Highway 224
Sullivan, OH 44880-9771
Mailing address
500 US Highway 224
Sullivan, OH 44880-9771
Phone (330) 736-2255
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000234003 | Other | OH | BCBS NON-PAR |
| 2530970 | Medicaid | OH | |
| 021434800 | Other | OH | BOARD OF PHARMACY |
Other names
- Sullivan Volunteer Fire Department
Other providers in Sullivan, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2024. 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.