Provider Demographics
NPI:1619216579
Name:CLEARCREEK TOWNSHIP FIRE DEPARTMENT
Entity Type:Organization
Organization Name:CLEARCREEK TOWNSHIP FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRIESBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-474-6438
Mailing Address - Street 1:10361 SPARTAN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1220
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:11042 MAIN ST
Practice Address - Street 2:
Practice Address - City:STOUTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43154-9706
Practice Address - Country:US
Practice Address - Phone:740-474-6438
Practice Address - Fax:740-474-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance