# VILLAGE OF ANTWERP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679772263
- **Authorized official:** ASHLEY MARIE MCDOUGALL AEMT (EMS BILLING CLERK)
- **Authorized official phone:** (419) 258-1832

## Contact information

- **Practice address:** 204 W. DAGGETT ST., ANTWERP, OH 45813
- **Practice address phone:** (419) 258-1832
- **Practice address fax:** (419) 258-2558
- **Mailing address:** PO BOX 1046, ANTWERP, OH 45813-1046
- **Mailing address phone:** (419) 258-1832
- **Mailing address fax:** (419) 258-2558

## Taxonomy

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

## Other

- **Enumeration date:** 07/13/2007
- **Last updated:** 11/17/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0220577 | MEDICAID PROVIDER \# | OH |