Healthcare Provider Details

I. General information

NPI: 1720297179
Provider Name (Legal Business Name): VILLAGE OF MARSHALLVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 S MAIN ST
MARSHALLVILLE OH
44645-9480
US

IV. Provider business mailing address

PO BOX 169
MARSHALLVILLE OH
44645-0169
US

V. Phone/Fax

Practice location:
  • Phone: 330-855-1000
  • Fax:
Mailing address:
  • Phone: 330-855-2491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number02-0832150
License Number StateOH

VIII. Authorized Official

Name: BARBARA STOLL
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 330-855-1000