Organization
COUNTY OF PUTNAM OFFICE OF AUDITOR
Active
Other names
Putnam County EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LEE KLEAR (DIRECTOR)
(419) 538-7315
Entity
Organization
Contact information
Practice address
117 DR THATYE DRIVE, GLANDORF, OH 45848
(419) 538-7315
(419) 538-7319
Mailing address
PO BOX 21727, CLEVELAND, OH 44121-0727
(440) 605-9117
(440) 442-4443
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000156068
ANTHEM BCBS
OH
05
—
0248244
—
OH
01
—
34640113700
BWC
OH
01
—
590012253
RAILROAD MEDICARE
OH
Enumeration date
05/24/2006
Last updated
10/18/2019
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