Organization
FULTON COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA SCHUETTE (CLERK)
(419) 337-9255
Entity
Organization
Contact information
Practice address
152 S FULTON ST, SUITE 250, WAUSEON, OH 43567
(419) 337-9255
(419) 337-9285
Mailing address
152 S FULTON ST, SUITE 250, WAUSEON, OH 43567
(419) 337-9207
(419) 337-9274
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
02-0307700
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000156057
ANTHEM BC/BS
OH
05
—
0429101
—
OH
01
—
10266
PARAMOUNT HEALTHCARE
OH
Enumeration date
08/31/2006
Last updated
09/21/2023
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