Provider Demographics
NPI:1972545523
Name:TOWNSHIP OF WOOSTER TTEES
Entity type:Organization
Organization Name:TOWNSHIP OF WOOSTER TTEES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-264-9786
Mailing Address - Street 1:1917 MILLERSBURG ROAD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691
Mailing Address - Country:US
Mailing Address - Phone:330-264-9786
Mailing Address - Fax:330-264-9786
Practice Address - Street 1:1917 MILLERSBURG RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-9409
Practice Address - Country:US
Practice Address - Phone:330-264-9786
Practice Address - Fax:330-264-9786
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWNSHIP OF WOOSTER TTEES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-11
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020325200341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9337311Medicare PIN