# WINCHESTER-WAYNE TOWNSHIP LIFE SQUAD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306838966
- **Authorized official:** JOSHUA CHANEY (CHIEF)
- **Authorized official phone:** (937) 695-0447

## Contact information

- **Practice address:** 35 WASHINGTON ST, BOX 215, WINCHESTER, OH 45697
- **Practice address phone:** (937) 695-0447
- **Mailing address:** 4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
- **Mailing address phone:** (800) 875-0136

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 08/19/2005
- **Last updated:** 09/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000010000 | ANTHEM | OH |
| 05 | — | 0457376 | — | OH |