Healthcare Provider Details

I. General information

NPI: 1255141628
Provider Name (Legal Business Name): GARRETT W CELLAR FIREFIGHTER/MEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 S FRONT ST APT 7
FREMONT OH
43420-3078
US

IV. Provider business mailing address

411 S FRONT ST APT 7
FREMONT OH
43420-3078
US

V. Phone/Fax

Practice location:
  • Phone: 419-685-0018
  • Fax:
Mailing address:
  • Phone: 419-685-0018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number177747
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: