Provider Demographics
NPI:1801959630
Name:COUNTY OF AUGLAIZE OFFICE OF COUNTY AUDITOR
Entity type:Organization
Organization Name:COUNTY OF AUGLAIZE OFFICE OF COUNTY AUDITOR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:
Authorized Official - First Name:OLIVER
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MS RS
Authorized Official - Phone:419-738-3410
Mailing Address - Street 1:813 DEFIANCE STREET
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895
Mailing Address - Country:US
Mailing Address - Phone:419-738-3410
Mailing Address - Fax:419-738-7818
Practice Address - Street 1:813 DEFIANCE STREET
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895
Practice Address - Country:US
Practice Address - Phone:419-738-3410
Practice Address - Fax:419-738-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE251K00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0980023Medicaid
OHFV91241Medicare ID - Type Unspecified