Provider Demographics
NPI:1467444281
Name:TRI-VILLAGE RESCUE SERVICES INC
Entity Type:Organization
Organization Name:TRI-VILLAGE RESCUE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-996-3155
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 1:320 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW MADISON
Practice Address - State:OH
Practice Address - Zip Code:45346-9794
Practice Address - Country:US
Practice Address - Phone:937-996-3155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000001119OtherANTHEM
OH0558794Medicaid
5900155555OtherRAILROAD MEDICARE
OH=========00OtherOHIO BWC
=========OtherTRICARE
=========OtherTRICARE
OH000000001119OtherANTHEM