Organization
TROY TOWNSHIP TRUSTEES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DAVID RICHARDSON EMT-P (EMS DIRECTOR)
(419) 833-5422
Entity
Organization
Contact information
Practice address
311 KROTZER AVE, LUCKEY, OH 43443
(419) 833-5422
(419) 833-4264
Mailing address
311 KROTZER AVE, LUCKEY, OH 43443-9758
(419) 833-5422
(419) 833-4264
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000156085
ANTHEM
OH
05
—
321833
—
OH
01
—
791590173
RAILROAD MEDICARE
OH
Enumeration date
04/17/2007
Last updated
08/09/2011
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