Provider Demographics
NPI:1679680649
Name:KILLBUCK TOWNSHIP
Entity Type:Organization
Organization Name:KILLBUCK TOWNSHIP
Other - Org Name:KILLBUCK TOWNSHIP FIRE & EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-276-0441
Mailing Address - Street 1:310 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KILLBUCK
Mailing Address - State:OH
Mailing Address - Zip Code:44637-9797
Mailing Address - Country:US
Mailing Address - Phone:330-276-0441
Mailing Address - Fax:330-276-6607
Practice Address - Street 1:340 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:KILLBUCK
Practice Address - State:OH
Practice Address - Zip Code:44637
Practice Address - Country:US
Practice Address - Phone:330-276-0441
Practice Address - Fax:330-276-6607
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KILLBUCK TOWNSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-24
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020833900341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2070539Medicaid
OH020833900OtherBOARD OF PHARMACY
OH2070539Medicaid