Healthcare Provider Details

I. General information

NPI: 1275652661
Provider Name (Legal Business Name): VILLAGE OF LOUDONVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N MARKET ST
LOUDONVILLE OH
44842-1217
US

IV. Provider business mailing address

PO BOX 150
LOUDONVILLE OH
44842-0150
US

V. Phone/Fax

Practice location:
  • Phone: 419-994-9400
  • Fax:
Mailing address:
  • Phone: 419-994-3214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. ELAINE VANHORN
Title or Position: FISCAL OFFICER
Credential:
Phone: 419-994-3214