Healthcare Provider Details

I. General information

NPI: 1124173422
Provider Name (Legal Business Name): SOUTHINGTON TOWNSHIP TRUSTEES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 05/23/2024
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4361 STATE ROUTE 305
SOUTHINGTON OH
44470-0187
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251
US

V. Phone/Fax

Practice location:
  • Phone: 330-898-6242
  • Fax:
Mailing address:
  • Phone: 800-962-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SCOTT BOWER
Title or Position: CHIEF
Credential:
Phone: 330-898-6242