MEDICARE: TOWNSHIP EMERGENCY MEDICAL SERVICE INC

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

General Provider Information

NPI Number	:	1699799288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWNSHIP EMERGENCY MEDICAL SERVICE INC

Provider Business Mailing Address
First Line	:	PO BOX 665
Second Line	:	10 S SALEM WARREN ROAD
City	:	NORTH JACKSON
State	:	OH
Zip	:	44451-0665
Country	:	US
Telephone Number	:	330-538-9840
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 S SALEM WARREN ROAD
Second Line	:	BOX 665
City	:	NORTH JACKSON
State	:	OH
Zip	:	44451-0665
Country	:	US
Telephone Number	:	330-538-9840
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD M PELLIN JR.
Credential	:	EMT-I
Telephone Number	:	330-538-9840

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	10/11/2007

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