Provider Demographics
NPI:1952728115
Name:VILLAGE OF GEORGETOWN
Entity type:Organization
Organization Name:VILLAGE OF GEORGETOWN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VILLAGE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:D
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-378-6395
Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-0405
Mailing Address - Country:US
Mailing Address - Phone:937-378-3082
Mailing Address - Fax:937-378-4709
Practice Address - Street 1:301 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-1500
Practice Address - Country:US
Practice Address - Phone:937-378-6395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH022461650-13341600000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP01321676OtherRAILROAD MEDICARE
OH0103909Medicaid
OH0103909Medicaid