Provider Demographics
NPI:1578555454
Name:FARMERSVILLE FIRE ASSOCIATION INC
Entity Type:Organization
Organization Name:FARMERSVILLE FIRE ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ERSIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-696-2863
Mailing Address - Street 1:207 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45325-1120
Mailing Address - Country:US
Mailing Address - Phone:937-696-2863
Mailing Address - Fax:937-696-9067
Practice Address - Street 1:207 N ELM ST
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45325-1120
Practice Address - Country:US
Practice Address - Phone:937-696-2863
Practice Address - Fax:937-696-9067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02034675013341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000246593OtherANTHEM
OH2378770Medicaid
OH590015514OtherRAILROAD MEDICARE
OH000000246593OtherANTHEM