Healthcare Provider Details

I. General information

NPI: 1699704429
Provider Name (Legal Business Name): CEDARVILLE TOWNSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 SOUTH ST
CEDARVILLE OH
45314-9753
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251-9907
US

V. Phone/Fax

Practice location:
  • Phone: 800-962-1484
  • Fax: 513-772-4464
Mailing address:
  • Phone: 800-962-1484
  • Fax: 513-772-4464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER ORR
Title or Position: FISCAL OFFICER
Credential:
Phone: 937-766-5851