MEDICARE: TOWNSHIP OF FREEDOM OFFICE OF CLERK

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
2	341600000X	Ambulance	02-0819700	OH

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	:	1346340114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWNSHIP OF FREEDOM OFFICE OF CLERK

Provider Business Mailing Address
First Line	:	PO BOX 836
Second Line	:
City	:	PEMBERVILLE
State	:	OH
Zip	:	43450-0836
Country	:	US
Telephone Number	:	419-287-4626
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 E FRONT ST
Second Line	:
City	:	PEMBERVILLE
State	:	OH
Zip	:	43450-7031
Country	:	US
Telephone Number	:	419-287-4626
Fax Number	:

Authorized Official
Title or Position	:	FIRE/EMS CHIEF
Name	:	DUANE DANIEL MARTIN
Credential	:
Telephone Number	:	419-287-4593

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	06/11/2024

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Directions to “TOWNSHIP OF FREEDOM OFFICE OF CLERK ” Practice Location

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