=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073668802
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CLINTON-WARREN JOINT FIRE & RESCUE DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2007
-----------------------------------------------------
Last Update Date | 04/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 82 SPRINGHILL RD
-----------------------------------------------------
City | CLARKSVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-289-3427
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 392907
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15251-9907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-962-1484
-----------------------------------------------------
Fax | 513-772-4464
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF
-----------------------------------------------------
Name | ANDREW WYSONG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 937-289-3427
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------