MEDICARE: TOWNSHIP OF CANTON BOARD OF 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	341600000X	Ambulance	020328100	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	590009241	OTHER	OH	RRMEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020328100	OTHER	OH	BOARD OF PHARMACY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000155965	OTHER	OH	BCBS
4	081119900	OTHER	OH	BLACKLUNG

General Provider Information

NPI Number	:	1154376556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWNSHIP OF CANTON BOARD OF TRUSTEES

Provider Business Mailing Address
First Line	:	210 38TH ST SE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44707-1304
Country	:	US
Telephone Number	:	330-484-6165
Fax Number	:	330-484-6135

Provider Business Practice Location Address
First Line	:	210 38TH ST SE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44707-1304
Country	:	US
Telephone Number	:	330-484-6165
Fax Number	:	330-484-6135

Authorized Official
Title or Position	:	BILLING COORDINATOR
Name	:	MR. SCOTT JOHNSON
Credential	:
Telephone Number	:	330-484-6165

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	03/04/2024

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Directions to “TOWNSHIP OF CANTON BOARD OF TRUSTEES ” Practice Location

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