Provider Demographics
NPI:1538926522
Name:HANOVER TOWNSHIP
Entity type:Organization
Organization Name:HANOVER TOWNSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:VICKROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-869-7141
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:HANOVERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44423-0335
Mailing Address - Country:US
Mailing Address - Phone:330-869-7141
Mailing Address - Fax:
Practice Address - Street 1:33555 STATE ROUTE 172
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432
Practice Address - Country:US
Practice Address - Phone:330-222-2610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0290000022OtherBOARD OF PHARMACY