Provider Demographics
NPI:1760691703
Name:VILLAGE OF BENTLEYVILLE
Entity Type:Organization
Organization Name:VILLAGE OF BENTLEYVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-247-5055
Mailing Address - Street 1:6253 CHAGRIN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BENTLEYVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44022-3337
Mailing Address - Country:US
Mailing Address - Phone:440-247-5055
Mailing Address - Fax:440-247-3755
Practice Address - Street 1:6253 CHAGRIN RIVER RD
Practice Address - Street 2:
Practice Address - City:BENTLEYVILLE
Practice Address - State:OH
Practice Address - Zip Code:44022-3337
Practice Address - Country:US
Practice Address - Phone:440-247-5055
Practice Address - Fax:440-247-3755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHVI9345061Medicare ID - Type Unspecified