Organization
WINCHESTER-WAYNE TOWNSHIP LIFE SQUAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA CHANEY (CHIEF)
(937) 695-0447
Entity
Organization
Contact information
Practice address
35 WASHINGTON ST, BOX 215, WINCHESTER, OH 45697
(937) 695-0447
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010000
ANTHEM
OH
05
—
0457376
—
OH
Enumeration date
08/19/2005
Last updated
09/13/2008
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