Provider Demographics
NPI:1518186071
Name:SALINE TWP TRUSTEES
Entity type:Organization
Organization Name:SALINE TWP TRUSTEES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOTSCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-219-0752
Mailing Address - Street 1:MAIN STREET
Mailing Address - Street 2:PO BOX 177
Mailing Address - City:HAMMONDSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43930
Mailing Address - Country:US
Mailing Address - Phone:330-532-2195
Mailing Address - Fax:330-532-5844
Practice Address - Street 1:164 COUNTY ROAD 50A
Practice Address - Street 2:
Practice Address - City:HAMMONDVILLE
Practice Address - State:OH
Practice Address - Zip Code:43930-0177
Practice Address - Country:US
Practice Address - Phone:513-612-3380
Practice Address - Fax:330-532-5844
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALINE TOWNSHIP TRUSTEES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-24
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0578050341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherTRICARE
OH2038100Medicaid
OH34600256OtherMEDMUTUAL
OH=========OtherTRICARE