Provider Demographics
NPI:1033263264
Name:TOWNSHIP OF EDINBURG TRUSTEES
Entity Type:Organization
Organization Name:TOWNSHIP OF EDINBURG TRUSTEES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT-P
Authorized Official - Phone:330-325-1224
Mailing Address - Street 1:6727 TALLMADGE RD
Mailing Address - Street 2:
Mailing Address - City:ROOTSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44272-9524
Mailing Address - Country:US
Mailing Address - Phone:330-325-1224
Mailing Address - Fax:330-325-8144
Practice Address - Street 1:6727 TALLMADGE RD
Practice Address - Street 2:
Practice Address - City:ROOTSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44272-9524
Practice Address - Country:US
Practice Address - Phone:330-325-1224
Practice Address - Fax:330-325-8144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2315104Medicaid
OH2315104Medicaid