Provider Demographics
NPI:1780613505
Name:HIGHLAND TOWNSHIP
Entity type:Organization
Organization Name:HIGHLAND TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-395-2206
Mailing Address - Street 1:PO BOX 392907
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9907
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:27723 WATSON RD
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-6845
Practice Address - Country:US
Practice Address - Phone:800-962-1484
Practice Address - Fax:513-772-4464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000359251OtherANTHEM
OH2531200Medicaid
OH=========002OtherMEDICAL MUTUAL OF OHIO
OH9348801Medicare PIN