Healthcare Provider Details

I. General information

NPI: 1750370367
Provider Name (Legal Business Name): OHIO CITY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S. MAIN ST.
OHIO CITY OH
45874
US

IV. Provider business mailing address

PO BOX 246
OHIO CITY OH
45874-0246
US

V. Phone/Fax

Practice location:
  • Phone: 419-965-2255
  • Fax:
Mailing address:
  • Phone: 800-962-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberFCY.021231000-13
License Number StateOH

VIII. Authorized Official

Name: ELISHA SUE MANKEY
Title or Position: FISCAL OFFICER
Credential:
Phone: 419-965-2255