MEDICARE: SE HARDIN NW UNION JOINT FIRE DISTRICT

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	3416L00300X	OH
2	341600000X	Ambulance

General Provider Information

NPI Number	:	1790135333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SE HARDIN NW UNION JOINT FIRE DISTRICT

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	:	937-354-2345

Provider Business Practice Location Address
First Line	:	212 S WHEELER ST
Second Line	:
City	:	MOUNT VICTORY
State	:	OH
Zip	:	43340-9717
Country	:	US
Telephone Number	:	937-354-2345
Fax Number	:	937-354-2345

Authorized Official
Title or Position	:	FISCAL OFFICER
Name	:	PAIGE WALLACE
Credential	:
Telephone Number	:	937-354-2345

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	07/18/2025

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