Healthcare Provider Details

I. General information

NPI: 1992872022
Provider Name (Legal Business Name): VILLAGE OF PLYMOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 MARY FATE PARK DR
PLYMOUTH OH
44865
US

IV. Provider business mailing address

48 W BROADWAY ST
PLYMOUTH OH
44865-1108
US

V. Phone/Fax

Practice location:
  • Phone: 419-687-5101
  • Fax: 419-687-9046
Mailing address:
  • Phone: 800-962-1484
  • Fax: 513-772-4464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DIANN JAMERSON
Title or Position: FISCAL OFFICER
Credential:
Phone: 419-687-4331