Provider Demographics
NPI:1891832440
Name:BLUFFTON VILLAGE
Entity Type:Organization
Organization Name:BLUFFTON VILLAGE
Other - Org Name:BLUFFTON EMS
Other - Org Type:Other Name
Authorized Official - Title/Position:VILLAGE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BASINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-236-1965
Mailing Address - Street 1:PO BOX 21727
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-0727
Mailing Address - Country:US
Mailing Address - Phone:440-605-9117
Mailing Address - Fax:440-442-4443
Practice Address - Street 1:115 EAST WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:OH
Practice Address - Zip Code:45817
Practice Address - Country:US
Practice Address - Phone:419-358-4050
Practice Address - Fax:419-358-8137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0302372Medicaid
OH9138994Medicare PIN