Healthcare Provider Details

I. General information

NPI: 1245203579
Provider Name (Legal Business Name): COUNTY OF AUGLAIZE OFFICE OF COUNTY AUDITOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 05/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13093 INFIRMARY RD
WAPAKONETA OH
45895-9325
US

IV. Provider business mailing address

13093 INFIRMARY RD COUNTY OF AUGLAIZE OFFICE OF COUNTY AUDITOR;
WAPAKONETA OH
45895-9325
US

V. Phone/Fax

Practice location:
  • Phone: 419-738-3816
  • Fax: 419-738-6684
Mailing address:
  • Phone: 419-738-3816
  • Fax: 419-738-6684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY K. SUDHOFF
Title or Position: ADMINISTRATOR
Credential: LNHA
Phone: 419-738-3816