Provider Demographics
NPI:1578634655
Name:BETHLEHEM FIRE & RESCUE, INC.
Entity Type:Organization
Organization Name:BETHLEHEM FIRE & RESCUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS BILLING COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-879-5800
Mailing Address - Street 1:34 MAIN ST S
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:OH
Mailing Address - Zip Code:44662-1141
Mailing Address - Country:US
Mailing Address - Phone:330-879-5800
Mailing Address - Fax:330-879-5815
Practice Address - Street 1:34 MAIN ST S
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:OH
Practice Address - Zip Code:44662-1141
Practice Address - Country:US
Practice Address - Phone:330-879-5800
Practice Address - Fax:330-879-5815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020304250341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH590013878OtherRRMEDICARE
OH2691994Medicaid
OH000000155935OtherBCBS
OH000000155935OtherBCBS
OH9352801Medicare PIN