MEDICARE: OSNABURG 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	341600000X	Ambulance	020632850	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020632850	OTHER	OH	BOARD OF PHARMACY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235281619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSNABURG TOWNSHIP TRUSTEES

Provider Business Mailing Address
First Line	:	7115 HILLVALE ST SE
Second Line	:
City	:	EAST CANTON
State	:	OH
Zip	:	44730-9437
Country	:	US
Telephone Number	:	330-488-0235
Fax Number	:	330-488-1744

Provider Business Practice Location Address
First Line	:	110 CHURCH ST W
Second Line	:
City	:	EAST CANTON
State	:	OH
Zip	:	44730-1122
Country	:	US
Telephone Number	:	330-488-1547
Fax Number	:	330-488-1928

Authorized Official
Title or Position	:	FISCAL OFFICER
Name	:	BRIAN D LOWERY
Credential	:
Telephone Number	:	330-488-0235

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	05/14/2024

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