Provider Demographics
NPI:1508921743
Name:DILLONVALE EMERGENCY MEDICAL SERVICE
Entity Type:Organization
Organization Name:DILLONVALE EMERGENCY MEDICAL SERVICE
Other - Org Name:DILLONVALE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:GERI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SLIVINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT-PARAMEDIC
Authorized Official - Phone:740-769-7872
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:DILLONVALE
Mailing Address - State:OH
Mailing Address - Zip Code:43917-0008
Mailing Address - Country:US
Mailing Address - Phone:740-769-7872
Mailing Address - Fax:740-769-7872
Practice Address - Street 1:154 MAIN STREET
Practice Address - Street 2:
Practice Address - City:DILLONVALE
Practice Address - State:OH
Practice Address - Zip Code:43917-0008
Practice Address - Country:US
Practice Address - Phone:740-769-7872
Practice Address - Fax:740-769-7872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH080004600OtherBLACK LUNG
OH590000744OtherRAILROAD
OH613681300OtherFEDERAL BWC
OH020327450OtherBOARD OF PHARMACY
OH000000155450OtherBLUE CROSS BLUE SHIELD
OH0491347Medicaid
OH000294443OtherMT. STATE
OH000000155450OtherBLUE CROSS BLUE SHIELD
OH590000744OtherRAILROAD