Provider Demographics
NPI:1912474867
Name:CARROLL TOWNSHIP TRUSTEES
Entity Type:Organization
Organization Name:CARROLL TOWNSHIP TRUSTEES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-346-0029
Mailing Address - Street 1:11080 W TOUSSAINT EAST RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-8820
Mailing Address - Country:US
Mailing Address - Phone:419-898-9621
Mailing Address - Fax:
Practice Address - Street 1:11080 W TOUSSAINT EAST RD
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-8820
Practice Address - Country:US
Practice Address - Phone:419-898-9621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport