# WILLIAMSPORT AND DEERCREEK EMERGENCY SQUAD

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

## Provider details

- **NPI number:** 1316948292
- **Authorized official:** GARY WRIGHT (CHIEF)
- **Authorized official phone:** (740) 986-4019

## Contact information

- **Practice address:** 405 MILL STREET, WILLIAMSPORT, OH 43164-9800
- **Practice address phone:** (440) 605-9117
- **Practice address fax:** (440) 442-4443
- **Mailing address:** PO BOX 21727, CLEVELAND, OH 44121-0727
- **Mailing address phone:** (440) 605-9117
- **Mailing address fax:** (440) 442-4443

## Taxonomy

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

## Other

- **Enumeration date:** 08/02/2005
- **Last updated:** 07/21/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000379087 | ANTHEM | OH |
| 05 | — | 2611276 | — | OH |
| 01 | — | P00237229 | RAILROAD MEDICARE | OH |