Provider Demographics
NPI:1760474597
Name:MUNSON FIRE DEPARTMENT INC.
Entity Type:Organization
Organization Name:MUNSON FIRE DEPARTMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-286-6797
Mailing Address - Street 1:PO BOX 621005
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45262-1005
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:
Practice Address - Street 1:12200 AUBURN RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9454
Practice Address - Country:US
Practice Address - Phone:937-619-3013
Practice Address - Fax:937-619-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000247008OtherANTHEM
OH2114894Medicaid
OHP00047644OtherRAILROAD MEDICARE
OH=========002OtherMEDICAL MUTUAL OF OHIO
OHP00047644OtherRAILROAD MEDICARE
OH000000247008OtherANTHEM
OHP00047644OtherRAILROAD MEDICARE