Provider Demographics
NPI:1285747550
Name:CHESTERLAND FIRE/RESCUE, INC.
Entity type:Organization
Organization Name:CHESTERLAND FIRE/RESCUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARGELIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-729-9951
Mailing Address - Street 1:PO BOX 74431
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-0531
Mailing Address - Country:US
Mailing Address - Phone:937-619-3064
Mailing Address - Fax:
Practice Address - Street 1:8552 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2643
Practice Address - Country:US
Practice Address - Phone:440-729-9951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000372669OtherANTHEM
OH3414655548002OtherMEDICAL MUTUAL OF OHIO
OH2594849Medicaid
OHP00267316OtherRAILROAD MEDICARE
OHP00267316OtherRAILROAD MEDICARE
OH=========-00OtherBWC
OH=========OtherTRICARE