Healthcare Provider Details

I. General information

NPI: 1811141872
Provider Name (Legal Business Name): SOUTHERN HIGHLAND JOINT FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 06/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MAPLE STREET
MOWRYSTOWN OH
45155
US

IV. Provider business mailing address

4750 HEMPSTEAD STATION DR
KETTERING OH
45429-5164
US

V. Phone/Fax

Practice location:
  • Phone: 937-402-7355
  • Fax:
Mailing address:
  • Phone: 888-709-4357
  • Fax: 937-619-3028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KEVIN MOSELY
Title or Position: FIRE CHIEF
Credential:
Phone: 937-402-7356