Provider Demographics
NPI:1164414025
Name:CLINTON TOWNSHIP
Entity Type:Organization
Organization Name:CLINTON TOWNSHIP
Other - Org Name:CLINTON TOWNSHIP FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-475-0022
Mailing Address - Street 1:PO BOX 643048
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-3048
Mailing Address - Country:US
Mailing Address - Phone:614-471-6854
Mailing Address - Fax:614-475-0023
Practice Address - Street 1:3820 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2426
Practice Address - Country:US
Practice Address - Phone:614-471-6854
Practice Address - Fax:614-475-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0309550341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000230169OtherANTHEM
OH2331177Medicaid
OH590015232OtherRAILROAD MEDICARE
OH9322481Medicare PIN