MEDICARE: M&M FIRE DEPARTMENT

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590010029	OTHER	OH	RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1669548004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M&M FIRE DEPARTMENT

Provider Business Mailing Address
First Line	:	77 S 4TH ST
Second Line	:
City	:	MCCONNELSVILLE
State	:	OH
Zip	:	43756-1201
Country	:	US
Telephone Number	:	740-962-3444
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 S 4TH ST
Second Line	:
City	:	MCCONNELSVILLE
State	:	OH
Zip	:	43756-1201
Country	:	US
Telephone Number	:	740-962-3444
Fax Number	:	740-962-4798

Authorized Official
Title or Position	:	EMS COORD
Name	:	WAYLON CLARK
Credential	:
Telephone Number	:	740-538-4548

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	09/11/2025

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Directions to “M&M FIRE DEPARTMENT ” Practice Location

Language	Start Address	Practice Location

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