Healthcare Provider Details

I. General information

NPI: 1376543587
Provider Name (Legal Business Name): XENIA TOWNSHIP BOARD OF TRUSTEES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 01/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 BRUSH ROW RD
XENIA OH
45385-8599
US

IV. Provider business mailing address

PO BOX 2064
MOUNT VERNON OH
43050-7264
US

V. Phone/Fax

Practice location:
  • Phone: 937-372-7857
  • Fax:
Mailing address:
  • Phone: 937-424-3701
  • Fax: 937-291-2971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number02-0758950
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: GREG BEEGLE
Title or Position: EMS DIRECTOR
Credential:
Phone: 937-372-7857