Provider Demographics
NPI:1255386652
Name:PLAIN TOWNSHIP TRUSTEES
Entity type:Organization
Organization Name:PLAIN TOWNSHIP TRUSTEES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:SHALENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-492-4089
Mailing Address - Street 1:2600 EASTON ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-2690
Mailing Address - Country:US
Mailing Address - Phone:330-492-4089
Mailing Address - Fax:330-493-1368
Practice Address - Street 1:2600 EASTON ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-2600
Practice Address - Country:US
Practice Address - Phone:330-492-4089
Practice Address - Fax:330-493-1368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020307750341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2129780Medicaid
OH000000156015OtherBCBS
OH128533400OtherUS DEPT LABOR
OH590013310OtherRRMEDICARE
OH020307750OtherBOARD OF PHARMACY
OH9303281Medicare PIN