Provider Demographics
NPI:1578671160
Name:PORTER TWP CLERK
Entity Type:Organization
Organization Name:PORTER TWP CLERK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:MISS
Authorized Official - First Name:FRANKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-574-5542
Mailing Address - Street 1:PO BOX 621005
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45262-1005
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:680 CENTER ST
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-1701
Practice Address - Country:US
Practice Address - Phone:740-574-5542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2654499Medicaid
OHP00295386OtherRAILROAD MEDICARE
OH000000477515OtherANTHEM
OH000000477515OtherANTHEM
OHP00295386OtherRAILROAD MEDICARE
OH=========00OtherBUREAU OF WORKERS COMP