Healthcare Provider Details

I. General information

NPI: 1982815098
Provider Name (Legal Business Name): SPENCER COMMUNITY FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 EAST LORAIN STREET
SPENCER OH
44275
US

IV. Provider business mailing address

PO BOX 82
SPENCER OH
44275-0082
US

V. Phone/Fax

Practice location:
  • Phone: 330-648-2724
  • Fax: 330-648-2735
Mailing address:
  • Phone: 330-648-2724
  • Fax: 330-648-2735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. GARY FLEGAL
Title or Position: BOARD CHAIRMAN
Credential:
Phone: 330-648-2724