Healthcare Provider Details

I. General information

NPI: 1154483204
Provider Name (Legal Business Name): CHAMPION TOWNSHIP TRUSTEES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 CHAMPION AVE W
WARREN OH
44483-1413
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251-9907
US

V. Phone/Fax

Practice location:
  • Phone: 330-847-0311
  • Fax: 330-847-0318
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
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: TOM DEMPSEY
Title or Position: CHIEF
Credential:
Phone: 330-847-0311