Healthcare Provider Details

I. General information

NPI: 1144265901
Provider Name (Legal Business Name): WILLIAMS COUNTY OFFICE OF AUDITOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9876 COUNTY ROAD 16
BRYAN OH
43506-9781
US

IV. Provider business mailing address

9876 COUNTY ROAD 16
BRYAN OH
43506-9781
US

V. Phone/Fax

Practice location:
  • Phone: 419-636-4508
  • Fax: 419-636-1269
Mailing address:
  • Phone: 419-636-4508
  • Fax: 419-636-1269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number314000000X
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier36-6149
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerMEDICARE SNF
# 2
Identifier0258073
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer

VIII. Authorized Official

Name: MR. JEFF WANGSNESS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 419-636-4508