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General NPI Number Information
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NPI Number | 1770507840
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Entity Type | Organization
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Legal Business Name | NATIONAL TRAIL VOLUNTEER FIRE
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 05/26/2022
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Provider Practice Location Address
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Address Line | 362 CHURCH ST.
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City | GRATIOT
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State | OH
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Zip | 43740-0165
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Country | US
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Telephone | 740-787-2466
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Fax | 740-787-1026
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Provider Business Mailing Address
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Address Line | PO BOX 165
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City | GRATIOT
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State | OH
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Zip | 43740-0165
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Country | US
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Telephone | 740-787-2466
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Fax | 740-787-1026
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | TOM ALLEN ROBERTS
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Credential |
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Telephone | 740-787-2466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | EMS.020309700
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License Number State | OH
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