Provider Demographics
NPI:1598986879
Name:VILLAGE OF GRAFTON
Entity Type:Organization
Organization Name:VILLAGE OF GRAFTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK-TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-926-2401
Mailing Address - Street 1:960 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:OH
Mailing Address - Zip Code:44044-1432
Mailing Address - Country:US
Mailing Address - Phone:440-926-2401
Mailing Address - Fax:440-926-9018
Practice Address - Street 1:960 MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:OH
Practice Address - Zip Code:44044-1432
Practice Address - Country:US
Practice Address - Phone:440-926-2401
Practice Address - Fax:440-926-9018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2531111Medicaid
OH9347641Medicare PIN