Healthcare Provider Details

I. General information

NPI: 1538926522
Provider Name (Legal Business Name): HANOVER TOWNSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10133 CHESTNUT LN
HANOVERTON OH
44423
US

IV. Provider business mailing address

PO BOX 335
HANOVERTON OH
44423-0335
US

V. Phone/Fax

Practice location:
  • Phone: 330-223-1807
  • Fax:
Mailing address:
  • Phone: 330-869-7141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateNULL

VIII. Authorized Official

Name: BOBBIE J VICKROY
Title or Position: FISCAL OFFICER
Credential:
Phone: 330-869-7141