Provider Demographics
NPI:1417555087
Name:HOCKING VALLEY MEDICAL GROUP TRANSPORTATION
Entity Type:Organization
Organization Name:HOCKING VALLEY MEDICAL GROUP TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-380-8389
Mailing Address - Street 1:PO BOX 228
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138
Mailing Address - Country:US
Mailing Address - Phone:740-380-4181
Mailing Address - Fax:740-385-9197
Practice Address - Street 1:1383 W HUNTER ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138
Practice Address - Country:US
Practice Address - Phone:740-380-0202
Practice Address - Fax:740-380-2734
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOCKING VALLEY MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)