Provider Demographics
NPI:1740217702
Name:TOWNSHIP OF PAINT WAYNE COUNTY
Entity Type:Organization
Organization Name:TOWNSHIP OF PAINT WAYNE COUNTY
Other - Org Name:PAINT TOWNSHIP FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-473-8859
Mailing Address - Street 1:PO BOX 178
Mailing Address - Street 2:
Mailing Address - City:MOUNT EATON
Mailing Address - State:OH
Mailing Address - Zip Code:44659-0178
Mailing Address - Country:US
Mailing Address - Phone:330-465-1358
Mailing Address - Fax:
Practice Address - Street 1:15987 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOUNT EATON
Practice Address - State:OH
Practice Address - Zip Code:44659
Practice Address - Country:US
Practice Address - Phone:330-359-5699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWNSHIP OF PAINT WAYNE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-27
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020757400341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherMEDICAL MUTUAL
OH2735366Medicaid
OHH088610Medicare PIN