=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760474498
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARION TOWNSHIP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2005
-----------------------------------------------------
Last Update Date | 05/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 762 E CENTER ST
-----------------------------------------------------
City | MARION
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43302-4347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-387-5404
-----------------------------------------------------
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 | BEN MEDDLES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 740-382-9819
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------