Organization
VILLAGE OF GNADENHUTTEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIM STULL (CLERK)
(740) 254-4307
Entity
Organization
Contact information
Practice address
131 N WALNUT ST, GNADENHUTTEN, OH 44629-0155
(740) 254-4307
Mailing address
214 W 3RD ST, DOVER, OH 44622-2965
(330) 602-5180
(330) 602-5471
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
79-201
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0337862
—
OH
01
—
RR MEDICARE
9230021
OH
Enumeration date
03/26/2007
Last updated
08/31/2007
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