Healthcare Provider Details

I. General information

NPI: 1598766453
Provider Name (Legal Business Name): CHARDON FIRE DEPARTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S HAMBDEN ST
CHARDON OH
44024-1219
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251-9907
US

V. Phone/Fax

Practice location:
  • Phone: 440-285-4665
  • Fax: 440-285-8320
Mailing address:
  • Phone: 800-962-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number02037925013
License Number StateOH

VIII. Authorized Official

Name: LARRY GASPER
Title or Position: FIRE CHIEF (ASST FIRE CHIEF)
Credential:
Phone: 440-279-0905