Provider Demographics
NPI:1104366301
Name:GENOA TOWNSHIP DELAWARE COUNTY
Entity Type:Organization
Organization Name:GENOA TOWNSHIP DELAWARE COUNTY
Other - Org Name:GENOA TOWNSHIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PONZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-568-2040
Mailing Address - Street 1:PO BOX L-3796
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-3796
Mailing Address - Country:US
Mailing Address - Phone:855-626-9660
Mailing Address - Fax:833-953-0588
Practice Address - Street 1:7049 BIG WALNUT RD
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:OH
Practice Address - Zip Code:43021-9592
Practice Address - Country:US
Practice Address - Phone:614-568-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020988200-13341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0219464Medicaid
OHP01845159OtherRAILROAD MEDICARE