Provider Demographics
NPI:1841337920
Name:WOODMERE VILLAGE
Entity type:Organization
Organization Name:WOODMERE VILLAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-292-4103
Mailing Address - Street 1:27899 CHAGRIN BLVD.
Mailing Address - Street 2:
Mailing Address - City:WOODMERE VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-831-9511
Mailing Address - Fax:216-292-7023
Practice Address - Street 1:27899 CHAGRIN BLVD.
Practice Address - Street 2:
Practice Address - City:WOODMERE VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-831-9511
Practice Address - Fax:216-292-7023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6595901OtherEMPLOYERS MUTUAL INC
OH2247269Medicare ID - Type Unspecified