MEDICARE: RUSHCREEK TOWNSHIP TRUSTEES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093866758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUSHCREEK TOWNSHIP TRUSTEES

Provider Business Mailing Address
First Line	:	10 HUNTER PL
Second Line	:
City	:	BELLEFONTAINE
State	:	OH
Zip	:	43311-3000
Country	:	US
Telephone Number	:	937-593-9748
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 SANDUSKY
Second Line	:
City	:	RUSHSYLVANIA
State	:	OH
Zip	:	43347
Country	:	US
Telephone Number	:	937-468-2740
Fax Number	:

Authorized Official
Title or Position	:	CLERK
Name	:	ANDREW JOHNSON
Credential	:
Telephone Number	:	937-468-2647

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	10/25/2013

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