Provider Demographics
NPI:1558305201
Name:WILMOT FIRE & RESCUE, INC.
Entity Type:Organization
Organization Name:WILMOT FIRE & RESCUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS LIASON
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-359-5995
Mailing Address - Street 1:204 MILL STREET
Mailing Address - Street 2:P.O. BOX 178
Mailing Address - City:WILMOT
Mailing Address - State:OH
Mailing Address - Zip Code:44689
Mailing Address - Country:US
Mailing Address - Phone:330-359-5995
Mailing Address - Fax:330-359-5896
Practice Address - Street 1:204 MILL STREET
Practice Address - Street 2:
Practice Address - City:WILMOT
Practice Address - State:OH
Practice Address - Zip Code:44689
Practice Address - Country:US
Practice Address - Phone:330-359-5995
Practice Address - Fax:330-359-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0151866Medicaid
OHQ015454OtherHOMETOWN HEALTH NETWORK
OHAN94184570001OtherCIGNA
OH590009783OtherRR MEDICARE
OH=========00OtherBWC
OH0151866Medicaid