MEDICARE: VILLAGE OF BEACH CITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance		OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	590013867	OTHER	OH	RRMEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000176108	OTHER	OH	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	34144902700	OTHER	OH	BWC

General Provider Information

NPI Number	:	1215964101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF BEACH CITY

Provider Business Mailing Address
First Line	:	PO BOX 695
Second Line	:
City	:	BEACH CITY
State	:	OH
Zip	:	44608-0695
Country	:	US
Telephone Number	:	330-756-2312
Fax Number	:	330-756-3199

Provider Business Practice Location Address
First Line	:	102 W MAIN ST
Second Line	:
City	:	BEACH CITY
State	:	OH
Zip	:	44608-9319
Country	:	US
Telephone Number	:	330-756-2664
Fax Number	:	330-756-2058

Authorized Official
Title or Position	:	CHIEF
Name	:	WILLIAM E ANDERSON
Credential	:
Telephone Number	:	330-756-2664

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	05/08/2024

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Directions to “VILLAGE OF BEACH CITY ” Practice Location

Language	Start Address	Practice Location

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