Provider Demographics
NPI:1487719761
Name:GREENTOWN VOLUNTEER FIRE DEPARTMENT, INC.
Entity type:Organization
Organization Name:GREENTOWN VOLUNTEER FIRE DEPARTMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GUENTHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-494-3002
Mailing Address - Street 1:10100 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-9413
Mailing Address - Country:US
Mailing Address - Phone:330-494-3002
Mailing Address - Fax:330-966-7266
Practice Address - Street 1:10100 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-9413
Practice Address - Country:US
Practice Address - Phone:330-494-3002
Practice Address - Fax:330-966-7266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2495536Medicaid
OH2495536Medicaid