CORPORATION OF VILLAGE OF PORT WILLIAM; NPI #1427189604

Contact Information

CORPORATION OF VILLAGE OF PORT WILLIAM

220 SECOND ST
PORT WILLIAM, OH 45164

Phone: 937-302-7010
Fax: 937-486-5300
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Ambulance	341600000X	59	Ambulance Service Provider
Land Transport	3416L0300X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for CORPORATION OF VILLAGE OF PORT WILLIAM

NPI # 1427189604

LBN Legal business name CORPORATION OF VILLAGE OF PORT WILLIAM

Authorized official KEN IANSON - (MAYOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/08/2007

Last updated 05/10/2011 - About 15 years ago

Identifiers

OH	License #	02-0327100
OH	Medicaid	2782118
OH	Other	000000525508	ANTHEM

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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