Provider Demographics
NPI:1700821840
Name:TATE TOWNSHIP TRUSTEES
Entity Type:Organization
Organization Name:TATE TOWNSHIP TRUSTEES
Other - Org Name:BETHEL-TATE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:STOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-734-4444
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 1:149 N EAST ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:OH
Practice Address - Zip Code:45106-1201
Practice Address - Country:US
Practice Address - Phone:800-962-1484
Practice Address - Fax:513-772-4464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000363097OtherANTHEM
OH2550681Medicaid
OHP01198943OtherRAILROAD MEDICARE
OH000000363097OtherANTHEM
OH=========OtherTRICARE 4 LIFE
OH000000363097OtherANTHEM