=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518186071
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SALINE TWP TRUSTEES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2007
-----------------------------------------------------
Last Update Date | 01/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 164 COUNTY ROAD 50A
-----------------------------------------------------
City | HAMMONDVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43930-0177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-612-3380
-----------------------------------------------------
Fax | 330-532-5844
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | MAIN STREET PO BOX 177
-----------------------------------------------------
City | HAMMONDSVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-532-2195
-----------------------------------------------------
Fax | 330-532-5844
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF
-----------------------------------------------------
Name | CALEB E GOTSCHALL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-219-0752
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 02-0578050
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------