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Organization
ALLEN CLAY JOINT FIRE DISTRICT
Active
Organization
ALLEN CLAY JOINT FIRE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TIMOTHY MUSOLF PARAMEDIC (FIRE CHIEF)
(419) 855-4733
Entity
Organization
Contact information
Practice address
3155 N. GENOA CLAY CENTER RD, GENOA, OH 43430-9464
(419) 855-4733
(419) 855-1074
Mailing address
PO BOX 21727, CLEVELAND, OH 44121-0727
(440) 605-9117
(440) 442-4443
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
NULL
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000203042
ANTHEM BCBS
OH
05
—
2266604
—
OH
01
—
590014700
RAILROAD MEDICARE
OH
Enumeration date
05/19/2006
Last updated
12/23/2019
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