Provider Demographics
NPI:1841222312
Name:CLINTON SOUTH FIRE DISTRICT
Entity Type:Organization
Organization Name:CLINTON SOUTH FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-783-9391
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:513-772-4464
Practice Address - Street 1:13501 ST RT 68 SOUTH
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:OH
Practice Address - Zip Code:45148
Practice Address - Country:US
Practice Address - Phone:800-962-1484
Practice Address - Fax:513-772-4464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000289750OtherANTHEM
OH590015615OtherRAILROAD MEDICARE
OH2385100Medicaid
OH000000289750OtherANTHEM
OH2385100Medicaid
OH590015615OtherRAILROAD MEDICARE