Healthcare Provider Details

I. General information

NPI: 1144385378
Provider Name (Legal Business Name): HAMBDEN TOWNSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9867 OLD STATE RD
CHARDON OH
44024-9530
US

IV. Provider business mailing address

9867 OLD STATE RD
CHARDON OH
44024-9530
US

V. Phone/Fax

Practice location:
  • Phone: 440-285-3329
  • Fax: 440-285-3799
Mailing address:
  • Phone: 440-285-3329
  • Fax: 440-285-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT HILDENBRAND
Title or Position: CHIEF
Credential:
Phone: 440-285-3329