Provider Demographics
NPI:1679506703
Name:MADISON COUNTY EMERGENCY MEDICAL DISTRICT
Entity Type:Organization
Organization Name:MADISON COUNTY EMERGENCY MEDICAL DISTRICT
Other - Org Name:MADISON COUNTY EMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-852-5309
Mailing Address - Street 1:91 STATE ROUTE 56 NW
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-8889
Mailing Address - Country:US
Mailing Address - Phone:740-490-7828
Mailing Address - Fax:
Practice Address - Street 1:91 STATE ROUTE 56 NW
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-8889
Practice Address - Country:US
Practice Address - Phone:740-852-5390
Practice Address - Fax:740-852-7501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000006192OtherANTHEM
OH0327391Medicaid
OH000000006192OtherANTHEM
OH9152211Medicare PIN