Provider Demographics
NPI:1376607762
Name:PERRY TWP TRUSTEES
Entity Type:Organization
Organization Name:PERRY TWP TRUSTEES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-221-2345
Mailing Address - Street 1:PO BOX 392907
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9907
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:
Practice Address - Street 1:2408 E BREESE RD
Practice Address - Street 2:
Practice Address - City:CRIDERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45806-9743
Practice Address - Country:US
Practice Address - Phone:419-221-2345
Practice Address - Fax:419-229-2840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2288162Medicaid
OH9313931Medicare ID - Type Unspecified