Provider Demographics
NPI:1619965464
Name:VILLAGE OF NEW WATERFORD
Entity Type:Organization
Organization Name:VILLAGE OF NEW WATERFORD
Other - Org Name:NEW WATERFORD E.M.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:SLAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-457-2225
Mailing Address - Street 1:PO BOX 392907
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:
Practice Address - Street 1:3766 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW WATERFORD
Practice Address - State:OH
Practice Address - Zip Code:44445-9762
Practice Address - Country:US
Practice Address - Phone:330-457-2225
Practice Address - Fax:330-457-9497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0858755Medicaid
OH0858755Medicaid