Healthcare Provider Details

I. General information

NPI: 1871723155
Provider Name (Legal Business Name): VILLAGE OF RARDEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MAIN ST
RARDEN OH
45671-9041
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251-9907
US

V. Phone/Fax

Practice location:
  • Phone: 740-372-7245
  • Fax: 740-372-0303
Mailing address:
  • Phone: 888-709-4357
  • Fax: 937-619-3028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number020323900
License Number StateOH

VIII. Authorized Official

Name: MISSY MONROE
Title or Position: EMT
Credential:
Phone: 740-372-7245