Provider Demographics
NPI:1669548004
Name:M&M FIRE DEPARTMENT
Entity type:Organization
Organization Name:M&M FIRE DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-962-3444
Mailing Address - Street 1:77 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MC CONNELSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43756-1201
Mailing Address - Country:US
Mailing Address - Phone:940-962-3444
Mailing Address - Fax:740-962-4798
Practice Address - Street 1:77 S 4TH ST
Practice Address - Street 2:
Practice Address - City:MC CONNELSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43756-1201
Practice Address - Country:US
Practice Address - Phone:940-962-3444
Practice Address - Fax:740-962-4798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0206940Medicaid
OH000000154994OtherBCBS
OH001704969OtherMTSTATE
OH=========00OtherBWC
OH0206940Medicaid