Provider Demographics
NPI:1023006483
Name:WORTHINGTON TOWNSHIP
Entity Type:Organization
Organization Name:WORTHINGTON TOWNSHIP
Other - Org Name:WORTHINGTON TOWNSHIP FIRE DEPARTMENT & EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-883-2473
Mailing Address - Street 1:PO BOX 501
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:OH
Mailing Address - Zip Code:44822-0501
Mailing Address - Country:US
Mailing Address - Phone:419-883-3532
Mailing Address - Fax:
Practice Address - Street 1:20 W ELM ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:OH
Practice Address - Zip Code:44822-9780
Practice Address - Country:US
Practice Address - Phone:419-883-3532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WORTHINGTON TOWNSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-11
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021186150341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH021186150OtherBOARD OF PHARMACY
P00459071OtherR/R MEDICARE
OH2452251Medicaid