Provider Demographics
NPI:1073759569
Name:SCIOTO AMBULANCE DISTRICT
Entity Type:Organization
Organization Name:SCIOTO AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-981-7502
Mailing Address - Street 1:4750 HEMPSTEAD STATION DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5164
Mailing Address - Country:US
Mailing Address - Phone:888-709-4357
Mailing Address - Fax:937-619-3028
Practice Address - Street 1:57 BARKER STREET
Practice Address - Street 2:
Practice Address - City:MCDERMOTT
Practice Address - State:OH
Practice Address - Zip Code:45652
Practice Address - Country:US
Practice Address - Phone:740-876-8093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport