Provider Demographics
NPI:1124195839
Name:CHARDON TOWNSHIP
Entity Type:Organization
Organization Name:CHARDON TOWNSHIP
Other - Org Name:CHARDON FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLUSARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-286-3711
Mailing Address - Street 1:9949 MENTOR RD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9601
Mailing Address - Country:US
Mailing Address - Phone:440-285-3711
Mailing Address - Fax:440-286-1941
Practice Address - Street 1:110 S HAMBDEN ST
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-1219
Practice Address - Country:US
Practice Address - Phone:440-286-3711
Practice Address - Fax:440-286-1941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020379250341600000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH020379250OtherBOARD OF PHARMACY
OH2741377Medicaid
P00172918OtherRR MEDICARE
OH34000585002OtherMEDMUTUAL
OHOOOOOO297437OtherBCBS