Provider Demographics
NPI:1700143542
Name:SANDY CREEK JOINT FIRE DISTRICT
Entity Type:Organization
Organization Name:SANDY CREEK JOINT FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:STOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-868-5193
Mailing Address - Street 1:505 E LINCOLNWAY
Mailing Address - Street 2:
Mailing Address - City:MINERVA
Mailing Address - State:OH
Mailing Address - Zip Code:44657-2007
Mailing Address - Country:US
Mailing Address - Phone:330-868-5193
Mailing Address - Fax:330-868-5193
Practice Address - Street 1:505 E LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-2007
Practice Address - Country:US
Practice Address - Phone:330-868-5193
Practice Address - Fax:330-868-5193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH022198100341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0071039Medicaid
OH022198100OtherPHARMACY