1306995626 NPI number — VINTON CO

Table of content: (NPI 1306995626)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306995626 NPI number — VINTON CO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VINTON CO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VINTON COUNTY COMMISSIONERS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306995626
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
836 4TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701-1407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-521-1576
Provider Business Mailing Address Fax Number:
304-521-1576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31931 SR 93 NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCARTHUR
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45651-8766
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-596-4123
Provider Business Practice Location Address Fax Number:
740-596-3718
Provider Enumeration Date:
01/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WOODRUM
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS DIRECTOR
Authorized Official Telephone Number:
740-596-4122

Provider Taxonomy Codes

  • Taxonomy code: 146L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X , with the licence number: 020972950 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2029923 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000155265 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".