Healthcare Provider Details

I. General information

NPI: 1619009545
Provider Name (Legal Business Name): MANTUA-SHALERSVILLE FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10303 STATE ROUTE 44
MANTUA OH
44255-9715
US

IV. Provider business mailing address

10303 STATE ROUTE 44
MANTUA OH
44255-9715
US

V. Phone/Fax

Practice location:
  • Phone: 330-274-3535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MATTHEW SCOTT BENNER
Title or Position: FIRE CHIEF
Credential:
Phone: 330-274-3535