Provider Demographics
NPI:1871291617
Name:TOWNSHIP OF BLOOMFIELD
Entity type:Organization
Organization Name:TOWNSHIP OF BLOOMFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-685-4734
Mailing Address - Street 1:2063 KINSMAN ROAD NW, PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:NORTH BLOOMFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44450
Mailing Address - Country:US
Mailing Address - Phone:440-685-4734
Mailing Address - Fax:
Practice Address - Street 1:8870 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH BLOOMFIELD
Practice Address - State:OH
Practice Address - Zip Code:44450-4445
Practice Address - Country:US
Practice Address - Phone:440-685-4734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH022057650OtherTERMINAL-EMS-LIMITED-CATEGORY 3