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Organization
WASHINGTON TOWNSHIP
Active
Organization
WASHINGTON TOWNSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY S BAUER (TRUSTEE)
(740) 858-2993
Entity
Organization
Contact information
Practice address
1900 S.S. DAVIS DR., WEST PORTSMOUTH, OH 45663
(740) 858-2993
Mailing address
10361 SPARTAN DR, CINCINNATI, OH 45215-1220
(800) 962-1484
(513) 772-4464
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
020320900
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000390657
ANTHEM
OH
05
—
2638613
—
OH
01
—
P00302665
RAILROAD MEDICARE
OH
Enumeration date
07/10/2006
Last updated
11/04/2016
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