Provider Demographics
NPI:1730309006
Name:BAINBRIDGE TOWNSHIP
Entity Type:Organization
Organization Name:BAINBRIDGE TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-543-9871
Mailing Address - Street 1:17822 CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-4855
Mailing Address - Country:US
Mailing Address - Phone:440-543-9871
Mailing Address - Fax:440-543-4654
Practice Address - Street 1:17822 CHILLICOTHE ROAD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023
Practice Address - Country:US
Practice Address - Phone:440-543-9871
Practice Address - Fax:440-543-4654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2495527Medicaid
OH2495527Medicaid