Provider Demographics
NPI:1144597519
Name:WEST LICKING JOINT FIRE DISTRICT
Entity Type:Organization
Organization Name:WEST LICKING JOINT FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-927-8699
Mailing Address - Street 1:PO BOX 2039
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-7239
Mailing Address - Country:US
Mailing Address - Phone:740-522-8815
Mailing Address - Fax:
Practice Address - Street 1:851 E BROAD ST
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-8199
Practice Address - Country:US
Practice Address - Phone:740-927-8699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020323500341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000755015OtherANTHEM
OH0062194Medicaid
OHP01020889OtherRAILROAD MEDICARE
OH0062194Medicaid