Provider Demographics
NPI:1821206491
Name:LICKING TWP EMERGENCY SQUAD AND FIRE DEPT INC
Entity Type:Organization
Organization Name:LICKING TWP EMERGENCY SQUAD AND FIRE DEPT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS LIEUTENANT
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-453-1888
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:NASHPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43830-0067
Mailing Address - Country:US
Mailing Address - Phone:740-453-1888
Mailing Address - Fax:740-450-8617
Practice Address - Street 1:6705 DILLON HILLS DR
Practice Address - Street 2:
Practice Address - City:NASHPORT
Practice Address - State:OH
Practice Address - Zip Code:43830-9798
Practice Address - Country:US
Practice Address - Phone:740-453-1888
Practice Address - Fax:740-450-8617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2163662Medicaid
OH2163662Medicaid
OHH175250Medicare PIN