Organization
ALLEN CLAY JOINT FIRE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TIMOTHY MUSOLF PARAMEDIC (FIRE CHIEF)
(419) 855-4733
Entity
Organization
Contact information
Practice address
3155 N. GENOA CLAY CENTER RD, GENOA, OH 43430-9464
(419) 855-4733
(419) 855-1074
Mailing address
PO BOX 21727, CLEVELAND, OH 44121-0727
(440) 605-9117
(440) 442-4443
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000203042
ANTHEM BCBS
OH
05
—
2266604
—
OH
01
—
590014700
RAILROAD MEDICARE
OH
Enumeration date
05/19/2006
Last updated
12/23/2019
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