Provider Demographics
NPI:1720297179
Name:VILLAGE OF MARSHALLVILLE
Entity Type:Organization
Organization Name:VILLAGE OF MARSHALLVILLE
Other - Org Name:MARSHALLVILLE FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-855-1000
Mailing Address - Street 1:PO BOX 169
Mailing Address - Street 2:
Mailing Address - City:MARSHALLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44645-0169
Mailing Address - Country:US
Mailing Address - Phone:330-855-2491
Mailing Address - Fax:
Practice Address - Street 1:4 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALLVILLE
Practice Address - State:OH
Practice Address - Zip Code:44645-9480
Practice Address - Country:US
Practice Address - Phone:330-855-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0832150341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
0292000358OtherBOARD OF PHARMACY
OH2864922Medicaid
OH9373381Medicare PIN