Organization
LIBERTY TOWNSHIP TRUSTEES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA KEERAN (BILLING MANAGER)
(937) 578-0264
Entity
Organization
Contact information
Practice address
21684 MAIN STREET, RAYMOND, OH 43067-0000
(937) 246-2156
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
05
—
0608408
—
OH
01
—
1842455
HIGHMARK BS
—
01
—
22000000297637
ANTHEM BC
—
01
—
473887
AETNA
—
01
—
590015613
RAILROAD MEDICARE
—
Enumeration date
01/04/2007
Last updated
07/22/2013
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