Provider Demographics
NPI:1053420083
Name:MERCER COUNTY
Entity type:Organization
Organization Name:MERCER COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:GARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-586-3797
Mailing Address - Street 1:321 RILEY ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822
Mailing Address - Country:US
Mailing Address - Phone:419-586-3797
Mailing Address - Fax:419-586-1866
Practice Address - Street 1:301 RILEY ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1648
Practice Address - Country:US
Practice Address - Phone:419-586-3797
Practice Address - Fax:419-586-1866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2016-10-12
Deactivation Date:2015-12-10
Deactivation Code:
Reactivation Date:2016-09-22
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9138561Medicare ID - Type Unspecified