MEDICARE: CLINTON HIGHLAND JOINT FIRE

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
2	000000369289	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1194717702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINTON HIGHLAND JOINT FIRE

Provider Business Mailing Address
First Line	:	PO BOX 392907
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9907
Country	:	US
Telephone Number	:	800-962-1484
Fax Number	:	513-772-4464

Provider Business Practice Location Address
First Line	:	676 WEST ST
Second Line	:	BOX 25
City	:	NEW VIENNA
State	:	OH
Zip	:	45159-9209
Country	:	US
Telephone Number	:	937-987-2713
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	JOHN JOHNSON
Credential	:
Telephone Number	:	937-987-2713

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	05/13/2024

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