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General NPI Number Information
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NPI Number | 1053531327
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Entity Type | Organization
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Legal Business Name | VILLAGE OF BRADY LAKE
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2123 MERRILL STREET
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City | RAVENNA
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State | OH
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Zip | 44266
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Country | US
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Telephone | 330-673-0365
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Fax | 330-673-5998
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Provider Business Mailing Address
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Address Line | 2123 MERRILL STREET
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City | RAVENNA
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State | OH
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Zip | 44266
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Country | US
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Telephone | 330-673-0365
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Fax | 330-673-5998
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Authorized Official
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Title or Position | FINANCE
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Name | MS. ETHEL NEMETH
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Credential |
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Telephone | 330-673-0365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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