# SYCAMORE VILLAGE OFFICE OF CLERK

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sycamore Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073509121
- **Authorized official:** MR. BRYAN CLOUSE (CHIEF)
- **Authorized official phone:** (419) 397-2063

## Contact information

- **Practice address:** 106 E SEVENTH ST, SYCAMORE, OH 44849
- **Practice address phone:** (419) 927-2900
- **Practice address fax:** (419) 927-2988
- **Mailing address:** PO BOX 77, 106 E SEVENTH STREET, SYCAMORE, OH 44882-0077
- **Mailing address phone:** (419) 927-2900
- **Mailing address fax:** (419) 927-2988

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 020299904 | OH | — |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 09/23/2005
- **Last updated:** 11/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0259081 | — | OH |
| 01 | — | 590007226 | RAILROAD MEDICARE PROVIDE | OH |