Provider Demographics
NPI:1205156494
Name:CHATHAM TOWNSHIP TTEES
Entity type:Organization
Organization Name:CHATHAM TOWNSHIP TTEES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR TRUSTEE
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-667-2276
Mailing Address - Street 1:P. O. BOX 99
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OH
Mailing Address - Zip Code:44275-0099
Mailing Address - Country:US
Mailing Address - Phone:330-667-6020
Mailing Address - Fax:330-667-6020
Practice Address - Street 1:6429 KOHLI DRIVE
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OH
Practice Address - Zip Code:44275-0057
Practice Address - Country:US
Practice Address - Phone:330-667-6020
Practice Address - Fax:330-667-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========Medicare PIN