Healthcare Provider Details

I. General information

NPI: 1487724233
Provider Name (Legal Business Name): VILLAGE OF MINGO JUNCTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 10/02/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 COMMERCIAL STREET
MINGO JUNCTION OH
43938-1233
US

IV. Provider business mailing address

836 4TH AVE
HUNTINGTON WV
25701-1407
US

V. Phone/Fax

Practice location:
  • Phone: 740-535-9165
  • Fax: 740-535-1125
Mailing address:
  • Phone: 304-521-1576
  • Fax: 304-521-1576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AUSTIN RAYMOND
Title or Position: FIRE CHIEF
Credential:
Phone: 740-535-9165