Provider Demographics
NPI:1629176904
Name:TOWNSHIP OF CONCORD TOWNSHIP TRUSTEES
Entity Type:Organization
Organization Name:TOWNSHIP OF CONCORD TOWNSHIP TRUSTEES
Other - Org Name:CONCORD TOWNSHIP FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SABO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-354-7503
Mailing Address - Street 1:11599 CONCORD HAMBDEN RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9516
Mailing Address - Country:US
Mailing Address - Phone:440-354-7504
Mailing Address - Fax:440-354-7507
Practice Address - Street 1:11599 CONCORD HAMBDEN RD.
Practice Address - Street 2:
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44077-9516
Practice Address - Country:US
Practice Address - Phone:440-354-7504
Practice Address - Fax:440-354-7507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherMEDICAL MUTUAL OF OHIO
OH2707244Medicaid
OHP00379329OtherRAILROAD MEDICARE
OH000000501655OtherANTHEM
OH=========OtherTRICARE 4 LIFE
OH31600075900OtherBUREAU OF WORKERS COMP
OH9363591Medicare PIN