Provider Demographics
NPI:1164499265
Name:MIDDLETON TOWNSHIP TRUSTEES
Entity Type:Organization
Organization Name:MIDDLETON TOWNSHIP TRUSTEES
Other - Org Name:MIDDLETON TOWNSHIP AMBULANCE MIDDLETON TOWNSHIP EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-823-1480
Mailing Address - Street 1:114 SUGAR ST
Mailing Address - Street 2:PO BOX 206
Mailing Address - City:HASKINS
Mailing Address - State:OH
Mailing Address - Zip Code:43525-0206
Mailing Address - Country:US
Mailing Address - Phone:419-823-1480
Mailing Address - Fax:419-823-1377
Practice Address - Street 1:114 SUGAR ST
Practice Address - Street 2:
Practice Address - City:HASKINS
Practice Address - State:OH
Practice Address - Zip Code:43525-0206
Practice Address - Country:US
Practice Address - Phone:419-823-1480
Practice Address - Fax:419-823-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0993877Medicaid
590009722OtherRAILROAD MEDICARE
632443OtherUNITED HEALTHCARE
080003200OtherFEDERAL BLACK LUNG
OH000000156084OtherANTHEM BLUE CROSS
OH0993877Medicaid