Provider Demographics
NPI:1255582433
Name:GREEN PERRYSVILLE JOINT FIRE DISTRICT
Entity type:Organization
Organization Name:GREEN PERRYSVILLE JOINT FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PURCELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-938-5822
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:LOUDONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44842-0270
Mailing Address - Country:US
Mailing Address - Phone:419-938-5822
Mailing Address - Fax:
Practice Address - Street 1:181 E 3RD ST
Practice Address - Street 2:
Practice Address - City:PERRYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44864-9569
Practice Address - Country:US
Practice Address - Phone:419-938-5822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020857050341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH020857050OtherBOARD OF PHARMACY
OH3016533Medicaid
OH000000600958OtherBCBS
OH9381111Medicare PIN