Provider Demographics
NPI:1093866758
Name:RUSHCREEK TOWNSHIP TRUSTEES
Entity Type:Organization
Organization Name:RUSHCREEK TOWNSHIP TRUSTEES
Other - Org Name:RUSHCREEK TWP FD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-468-2647
Mailing Address - Street 1:10 HUNTER PL
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-3000
Mailing Address - Country:US
Mailing Address - Phone:937-593-9748
Mailing Address - Fax:
Practice Address - Street 1:108 SANDUSKY
Practice Address - Street 2:
Practice Address - City:RUSHSYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43347
Practice Address - Country:US
Practice Address - Phone:937-468-2740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2014117Medicaid
OH2014117Medicaid
OH9287961Medicare ID - Type UnspecifiedAMBULANCE SERVICE