Provider Demographics
NPI:1053300848
Name:CROSBY TOWNSHIP
Entity Type:Organization
Organization Name:CROSBY TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-738-1831
Mailing Address - Street 1:10361 SPARTAN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1220
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:8910 WILLEY RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-9774
Practice Address - Country:US
Practice Address - Phone:513-738-1831
Practice Address - Fax:513-738-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH290480001OtherCARESOURCE
OH000000036818OtherANTHEM BCBS
OH2390256Medicaid
OH=========OtherTRICARE 4 LIFE
OH000000036818OtherANTHEM BCBS
OH=========002OtherMEDICAL MUTUAL OF OHIO
OH=========00OtherBUREAU OF WORKERS COMP