Healthcare Provider Details

I. General information

NPI: 1780801340
Provider Name (Legal Business Name): VALLEY VIEW TOWN HALL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6895 HATHAWAY ROAD
VALLEY VIEW OH
44125
US

IV. Provider business mailing address

6848 HATHAWAY RD
VALLEY VIEW OH
44125-4767
US

V. Phone/Fax

Practice location:
  • Phone: 216-524-6469
  • Fax: 216-524-9364
Mailing address:
  • Phone: 216-524-6469
  • Fax: 216-524-9364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. THOMAS KOSCIELSKI
Title or Position: CHIEF
Credential:
Phone: 216-524-6469