Healthcare Provider Details
I. General information
NPI: 1215929823
Provider Name (Legal Business Name): SRWW JOINT FIRE DISTRICT 2
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2005
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
179 S JACKSON ST
SABINA OH
45169-1333
US
IV. Provider business mailing address
PO BOX 392907
PITTSBURGH PA
15251-9907
US
V. Phone/Fax
- Phone: 937-584-4132
- Fax:
- Phone: 800-962-1484
- Fax: 513-772-4464
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 020326750 |
| License Number State | OH |
VIII. Authorized Official
Name:
CHUCK
GASKINS
Title or Position: CHIEF
Credential:
Phone: 937-584-4132