Healthcare Provider Details

I. General information

NPI: 1164422309
Provider Name (Legal Business Name): SARDINIA LIFE SQUAD AND RESCUE UNIT OF BROWN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 WINCHESTER ST
SARDINIA OH
45171-9326
US

IV. Provider business mailing address

PO BOX 621005
CINCINNATI OH
45262-1005
US

V. Phone/Fax

Practice location:
  • Phone: 937-446-2178
  • Fax:
Mailing address:
  • Phone: 800-962-1484
  • Fax: 513-772-4464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DARCY L HAMM
Title or Position: TREASURER
Credential:
Phone: 513-490-1676