Provider Demographics
NPI:1780676395
Name:MIFFLIN TOWNSHIP TRUSTEES
Entity Type:Organization
Organization Name:MIFFLIN TOWNSHIP TRUSTEES
Other - Org Name:MIFFLIN TOWNSHIP DIVISION OF FIRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:KAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-471-0542
Mailing Address - Street 1:PO BOX 634352
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-4352
Mailing Address - Country:US
Mailing Address - Phone:614-471-4494
Mailing Address - Fax:
Practice Address - Street 1:400 W. JOHNSTOWN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-2733
Practice Address - Country:US
Practice Address - Phone:614-471-4494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0308953341600000X
OHFCY.020308951-13341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2519653Medicaid
OHP00212523OtherRAILROAD MEDICARE
OH000000362181OtherANTHEM
OHP00212523OtherRAILROAD MEDICARE