Provider Demographics
NPI:1689402109
Name:CRAIG BEACH FIRE DEPARTMENT
Entity type:Organization
Organization Name:CRAIG BEACH FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-654-2107
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:LAKE MILTON
Mailing Address - State:OH
Mailing Address - Zip Code:44429-0099
Mailing Address - Country:US
Mailing Address - Phone:330-654-2107
Mailing Address - Fax:
Practice Address - Street 1:1797 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:LAKE MILTON
Practice Address - State:OH
Practice Address - Zip Code:44429
Practice Address - Country:US
Practice Address - Phone:330-654-2107
Practice Address - Fax:330-654-4157
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VILLAGE OF CRAIG BEACH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport