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General NPI Number Information
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NPI Number | 1609821396
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Entity Type | Organization
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Legal Business Name | COUNTY OF PUTNAM
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 10170 ROAD 5H
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City | OTTAWA
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State | OH
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Zip | 45875-9715
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Country | US
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Telephone | 419-523-4092
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Fax | 419-523-0021
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Provider Business Mailing Address
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Address Line | 10170 ROAD 5H
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City | OTTAWA
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State | OH
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Zip | 45875-9715
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Country | US
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Telephone | 419-523-4092
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Fax | 419-523-0021
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Authorized Official
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Title or Position | SR. VICE PRESIDENT
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Name | PAUL PLEVYAK
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Credential |
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Telephone | 502-213-1710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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