MEDICARE: WASHINGTON TOWNSHIP

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	020320900	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00302665	OTHER	OH	RAILROAD MEDICARE

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
2	000000390657	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1992739551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON TOWNSHIP

Provider Business Mailing Address
First Line	:	10361 SPARTAN DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-1220
Country	:	US
Telephone Number	:	800-962-1484
Fax Number	:	513-772-4464

Provider Business Practice Location Address
First Line	:	1900 S.S. DAVIS DR.
Second Line	:
City	:	WEST PORTSMOUTH
State	:	OH
Zip	:	45663
Country	:	US
Telephone Number	:	740-858-2993
Fax Number	:

Authorized Official
Title or Position	:	TRUSTEE
Name	:	JEFFREY S BAUER
Credential	:
Telephone Number	:	740-858-2993

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	11/04/2016

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Directions to “WASHINGTON TOWNSHIP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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