MEDICARE: VILLAGE OF NEW STRAITSVILLE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1104030857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF NEW STRAITSVILLE CORP

Provider Business Mailing Address
First Line	:	PO BOX 238
Second Line	:
City	:	NEW STRAITSVILLE
State	:	OH
Zip	:	43766-0238
Country	:	US
Telephone Number	:	740-394-2425
Fax Number	:	740-394-2522

Provider Business Practice Location Address
First Line	:	116 W MAIN ST
Second Line	:
City	:	NEW STRAITSVILLE
State	:	OH
Zip	:	43766-9547
Country	:	US
Telephone Number	:	740-394-2425
Fax Number	:	740-394-2522

Authorized Official
Title or Position	:	FISCAL OFFICER
Name	:	SUSAN L MILLER
Credential	:
Telephone Number	:	740-394-2425

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	02/13/2023

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