Provider Demographics
NPI:1316084510
Name:HINCKLEY TOWNSHIP TTEES
Entity type:Organization
Organization Name:HINCKLEY TOWNSHIP TTEES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SWEDYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-278-2591
Mailing Address - Street 1:1410 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44233-9611
Mailing Address - Country:US
Mailing Address - Phone:330-278-2591
Mailing Address - Fax:330-278-2605
Practice Address - Street 1:1410 RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:HINCKLEY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44233-9611
Practice Address - Country:US
Practice Address - Phone:330-278-2591
Practice Address - Fax:330-278-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2335548Medicaid
OH9318511Medicare PIN