Provider Demographics
NPI:1326315847
Name:VILLAGE OF MIDVALE
Entity Type:Organization
Organization Name:VILLAGE OF MIDVALE
Other - Org Name:MIDVALE-BARNHILL-BRIGHTWOOD VOL FD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-339-1939
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:OH
Mailing Address - Zip Code:44653-0227
Mailing Address - Country:US
Mailing Address - Phone:330-339-1939
Mailing Address - Fax:330-339-8986
Practice Address - Street 1:3111 BARNHILL ROAD
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:OH
Practice Address - Zip Code:44653-0227
Practice Address - Country:US
Practice Address - Phone:330-339-1939
Practice Address - Fax:330-339-8986
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VILLAGE OF MIDVALE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-29
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020987400341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0079583Medicaid
OHH068230Medicare PIN