Provider Demographics
NPI:1811500812
Name:COUNTY OF OTTAWA
Entity type:Organization
Organization Name:COUNTY OF OTTAWA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-262-3600
Mailing Address - Street 1:8180 W STATE ROUTE 163
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-8855
Mailing Address - Country:US
Mailing Address - Phone:567-262-3600
Mailing Address - Fax:
Practice Address - Street 1:8180 W STATE ROUTE 163
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-8855
Practice Address - Country:US
Practice Address - Phone:567-262-3600
Practice Address - Fax:419-898-9501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF OTTAWA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6635172Medicaid