Healthcare Provider Details

I. General information

NPI: 1386643617
Provider Name (Legal Business Name): WOOD COUNTY AUDITOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 E GYPSY LANE RD
BOWLING GREEN OH
43402-9564
US

IV. Provider business mailing address

1965 E GYPSY LANE RD
BOWLING GREEN OH
43402-9396
US

V. Phone/Fax

Practice location:
  • Phone: 419-353-8411
  • Fax: 419-353-2394
Mailing address:
  • Phone: 419-353-8411
  • Fax: 419-353-2394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateOH

VIII. Authorized Official

Name: DAVID CECIL
Title or Position: ADMINISTRATOR
Credential: LNHA
Phone: 419-353-8411