Provider Demographics
NPI:1821014978
Name:VILLAGE OF LEETONIA
Entity Type:Organization
Organization Name:VILLAGE OF LEETONIA
Other - Org Name:LEETONIA FIRE DEPT AND EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GARLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-427-6721
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEETONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44431-1137
Mailing Address - Country:US
Mailing Address - Phone:330-427-6721
Mailing Address - Fax:
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEETONIA
Practice Address - State:OH
Practice Address - Zip Code:44431-1137
Practice Address - Country:US
Practice Address - Phone:330-427-6721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2642395Medicaid
OH9358021Medicare ID - Type UnspecifiedTRANSPORTATION