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Organization

COUNTRY CARRIAGE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TARI ANNE HOOVER (CO-PARTENER)
(330) 356-9022
Entity
Organization

Contact information

Practice address
10180 GERDANVILLE AVE SE, WAYNESBURG, OH 44688-9323
(330) 356-9022
Mailing address
PO BOX 173, WAYNESBURG, OH 44688-0173
(330) 356-9022

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
4161822
OH

Other

Enumeration date
04/19/2018
Last updated
04/19/2018
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