Provider Demographics
NPI:1982815098
Name:SPENCER COMMUNITY FIRE DISTRICT
Entity Type:Organization
Organization Name:SPENCER COMMUNITY FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-648-2724
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OH
Mailing Address - Zip Code:44275-0082
Mailing Address - Country:US
Mailing Address - Phone:330-648-2724
Mailing Address - Fax:330-648-2735
Practice Address - Street 1:105 EAST LORAIN STREET
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OH
Practice Address - Zip Code:44275
Practice Address - Country:US
Practice Address - Phone:330-648-2724
Practice Address - Fax:330-648-2735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2530381Medicaid
OH2530381Medicaid