=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558305201
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILMOT FIRE & RESCUE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2006
-----------------------------------------------------
Last Update Date | 05/20/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 204 MILL STREET
-----------------------------------------------------
City | WILMOT
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-359-5995
-----------------------------------------------------
Fax | 330-359-5896
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 204 MILL STREET P.O. BOX 178
-----------------------------------------------------
City | WILMOT
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-359-5995
-----------------------------------------------------
Fax | 330-359-5896
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EMS LIASON
-----------------------------------------------------
Name | FRANCES E MILLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 330-359-5995
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------