Organization
COLLEGE TOWNSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA RAMBO (FISCAL OFFICER)
(740) 427-3394
Entity
Organization
Contact information
Practice address
102 E. BROOKLYN STREET, GAMBIER, OH 43022
(740) 427-3394
Mailing address
102 E. BROOKLYN STREET, GAMBIER, OH 43022-9704
(740) 427-3394
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0186957
—
OH
Enumeration date
07/18/2016
Last updated
05/01/2017
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