Provider Demographics
NPI:1194075192
Name:HARRISON TOWNSHIP CLERK
Entity type:Organization
Organization Name:HARRISON TOWNSHIP CLERK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-819-2348
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:PHILO
Mailing Address - State:OH
Mailing Address - Zip Code:43771-0215
Mailing Address - Country:US
Mailing Address - Phone:740-674-4325
Mailing Address - Fax:
Practice Address - Street 1:351 FRONT ST
Practice Address - Street 2:
Practice Address - City:PHILO
Practice Address - State:OH
Practice Address - Zip Code:43771-0167
Practice Address - Country:US
Practice Address - Phone:740-674-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-17
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHEMS.022065100-133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0081344Medicaid