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Organization
GEORGETOWN VOLUNTEER LIFE SQUAD ASSOCIATION
Active
Organization
GEORGETOWN VOLUNTEER LIFE SQUAD ASSOCIATION
Active
Other names
Georgetown Life Squad
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA MCKINZIE (EMS)
(937) 378-2101
Entity
Organization
Contact information
Practice address
821 MT. ORAB PIKE, GEORGETOWN, OH 45121
(937) 378-3082
(937) 378-4709
Mailing address
PO BOX 184, GEORGETOWN, OH 45121-0184
(937) 291-7850
(937) 291-2971
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000006129
ANTHEM
OH
05
—
0294168
—
OH
Enumeration date
07/29/2005
Last updated
03/13/2008
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