Healthcare Provider Details

I. General information

NPI: 1508115783
Provider Name (Legal Business Name): TOWNSHIP OF CLINTON TRUSTEES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 05/24/2024
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E MCCONKEY STREET
SHREVE OH
44676
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251-9907
US

V. Phone/Fax

Practice location:
  • Phone: 330-567-3411
  • Fax: 330-567-0037
Mailing address:
  • Phone: 888-709-4357
  • Fax: 937-619-3028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: SCOTT ERVIN
Title or Position: CHIEF
Credential:
Phone: 330-262-0294