Provider Demographics
NPI:1750501805
Name:FARMINGTON TOWNSHIP
Entity Type:Organization
Organization Name:FARMINGTON TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLISBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-889-3024
Mailing Address - Street 1:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:WEST FARMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44491-0081
Mailing Address - Country:US
Mailing Address - Phone:330-889-3024
Mailing Address - Fax:330-889-9390
Practice Address - Street 1:151 COLLEGE ST.
Practice Address - Street 2:
Practice Address - City:WEST FARMINGTON
Practice Address - State:OH
Practice Address - Zip Code:44491-0081
Practice Address - Country:US
Practice Address - Phone:330-889-3024
Practice Address - Fax:330-889-9390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000294667OtherANTHEM GROUP ID
OH2422971Medicaid
OHFA9333811Medicare ID - Type UnspecifiedAMBULANCE