Provider Demographics
NPI:1104030857
Name:VILLAGE OF NEW STRAITSVILLE CORP
Entity Type:Organization
Organization Name:VILLAGE OF NEW STRAITSVILLE CORP
Other - Org Name:VILLAGE OF NEW STRAITSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-394-2425
Mailing Address - Street 1:PO BOX 238
Mailing Address - Street 2:
Mailing Address - City:NEW STRAITSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43766-0238
Mailing Address - Country:US
Mailing Address - Phone:740-394-2425
Mailing Address - Fax:740-394-2522
Practice Address - Street 1:116 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW STRAITSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43766-9547
Practice Address - Country:US
Practice Address - Phone:740-394-2425
Practice Address - Fax:740-394-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000155271OtherANTHEM
OH0676308Medicaid
590014529Medicare ID - Type UnspecifiedRR MEDICARE
OH9223351Medicare ID - Type Unspecified