Healthcare Provider Details

I. General information

NPI: 1235281619
Provider Name (Legal Business Name): OSNABURG TOWNSHIP TRUSTEES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CHURCH ST W
EAST CANTON OH
44730-1122
US

IV. Provider business mailing address

7115 HILLVALE ST SE
EAST CANTON OH
44730-9437
US

V. Phone/Fax

Practice location:
  • Phone: 330-488-1547
  • Fax: 330-488-1928
Mailing address:
  • Phone: 330-488-0235
  • Fax: 330-488-1744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number020632850
License Number StateOH

VIII. Authorized Official

Name: BRIAN D LOWERY
Title or Position: FISCAL OFFICER
Credential:
Phone: 330-488-0235