Provider Demographics
NPI:1417729773
Name:FAYETTE COUNTY EMERGENCY MEDICAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:FAYETTE COUNTY EMERGENCY MEDICAL SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-477-6012
Mailing Address - Street 1:PO BOX 2122
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-1122
Mailing Address - Country:US
Mailing Address - Phone:800-926-6985
Mailing Address - Fax:734-479-6319
Practice Address - Street 1:115 E TEMPLE ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-1339
Practice Address - Country:US
Practice Address - Phone:740-335-6137
Practice Address - Fax:740-333-3588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport