Provider Demographics
NPI:1235126095
Name:LIBERTY TOWNSHIP TRUSTEES
Entity Type:Organization
Organization Name:LIBERTY TOWNSHIP TRUSTEES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:STUMPF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-759-7530
Mailing Address - Street 1:PO BOX 621005
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45262-1005
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:6400 PRINCETON RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-8409
Practice Address - Country:US
Practice Address - Phone:513-759-7530
Practice Address - Fax:513-759-7531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000021475OtherANTHEM BCBS
OH116820001OtherCARESOURCE
OH0381751Medicaid
OH590006246OtherRAILROAD MEDICARE
OH590006246OtherRAILROAD MEDICARE
OH=========00OtherBUREAU OF WORKERS COMP
OH=========OtherTRICARE 4 LIFE
OH=========OtherTRICARE 4 LIFE