Healthcare Provider Details

I. General information

NPI: 1184983546
Provider Name (Legal Business Name): SOUTH WEBSTER BLOOM TWP FIRE DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 MARKET ST
SOUTH WEBSTER OH
45682-0000
US

IV. Provider business mailing address

PO BOX 621005
CINCINNATI OH
45262-1005
US

V. Phone/Fax

Practice location:
  • Phone: 740-778-2555
  • Fax:
Mailing address:
  • Phone: 513-772-4465
  • Fax: 513-772-4464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SCOTT STEWART
Title or Position: FIRE CHIEF
Credential:
Phone: 740-778-2555