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General NPI Number Information
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NPI Number | 1619920030
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Entity Type | Organization
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Legal Business Name | TRI-DIVISION AMBULANCE DISTRICT
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 9333 MAIN STREET
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City | EAST SPARTA
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State | OH
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Zip | 44626
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Country | US
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Telephone | 330-866-9193
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Fax | 330-866-1879
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Provider Business Mailing Address
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Address Line | PO BOX 352
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City | EAST SPARTA
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State | OH
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Zip | 44626-0352
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Country | US
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Telephone | 330-866-9193
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Fax | 330-866-1879
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Authorized Official
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Title or Position | CHIEF
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Name | MRS. DARLA ADAMS
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Credential |
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Telephone | 330-866-9193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 02-0316200
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License Number State | OH
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