Organization
MAD RIVER TOWNSHIP
Active
Other names
Hustead EMS Department
Organization subpart
No
Provider details
NPI number
Authorized official
ILVA RICHARDS (CHIEF)
(937) 324-3031
Entity
Organization
Contact information
Practice address
6215 SPRINGFIELD XENIA RD, SPRINGFIELD, OH 45502-8142
(800) 962-1484
(513) 772-4464
Mailing address
PO BOX 621005, CINCINNATI, OH 45262-1005
(800) 962-1484
(513) 772-4464
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155258
ANTHEM
OH
05
—
2163671
—
OH
Enumeration date
06/25/2006
Last updated
08/22/2020
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