=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578671160
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PORTER TWP CLERK
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2006
-----------------------------------------------------
Last Update Date | 05/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 680 CENTER ST
-----------------------------------------------------
City | WHEELERSBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45694-1701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-574-5542
-----------------------------------------------------
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 | FISCAL OFFICER
-----------------------------------------------------
Name | MISS TED ADAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 740-574-5542
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------