Healthcare Provider Details

I. General information

NPI: 1710044615
Provider Name (Legal Business Name): SUFFIELD TOWNSHIP TRUSTEES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1256 WATERLOO RD
MOGADORE OH
44260-9579
US

IV. Provider business mailing address

1256 WATERLOO RD
MOGADORE OH
44260-9579
US

V. Phone/Fax

Practice location:
  • Phone: 330-628-9240
  • Fax: 330-628-5000
Mailing address:
  • Phone: 330-628-9240
  • Fax: 330-628-5000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ROBERT L RASNICK
Title or Position: FIRE CHIEF
Credential:
Phone: 330-628-9240