Provider Demographics
NPI:1538141833
Name:TOWNSHIP OF FOWLER TRUSTEES
Entity Type:Organization
Organization Name:TOWNSHIP OF FOWLER TRUSTEES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-448-6220
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:OH
Mailing Address - Zip Code:44418-0174
Mailing Address - Country:US
Mailing Address - Phone:330-637-2653
Mailing Address - Fax:330-638-5918
Practice Address - Street 1:3386 YOUNGSTOWN KINGSVILLE RD
Practice Address - Street 2:
Practice Address - City:FOWLER
Practice Address - State:OH
Practice Address - Zip Code:44418-0174
Practice Address - Country:US
Practice Address - Phone:330-637-2653
Practice Address - Fax:330-638-5918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000179790OtherANTHEM
OH0773408Medicaid
OH=========002OtherMEDICAL MUTUAL
OH=========00OtherWORK COMP
OH9235301Medicare PIN