MEDICARE: WOOD COUNTY AUDITOR

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	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750712782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOOD COUNTY AUDITOR

Provider Business Mailing Address
First Line	:	1840 E GYPSY LANE RD
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43402-9173
Country	:	US
Telephone Number	:	419-352-8402
Fax Number	:	419-354-2169

Provider Business Practice Location Address
First Line	:	1840 E GYPSY LANE RD
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43402-9173
Country	:	US
Telephone Number	:	419-352-8402
Fax Number	:	419-354-2169

Authorized Official
Title or Position	:	CEO
Name	:	LINDSEY RUIVIVAR
Credential	:
Telephone Number	:	419-352-8402

Provider Enumeration Date	:	12/02/2013
Last Update Date	:	08/16/2024

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Directions to “WOOD COUNTY AUDITOR ” Practice Location

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