1356348601 NPI number — STEUBEN COUNTY AUDITOR

Table of content: (NPI 1356348601)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356348601 NPI number — STEUBEN COUNTY AUDITOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEUBEN COUNTY AUDITOR
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:
STEUBEN COUNTY EMS
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:
1356348601
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2122
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVERVIEW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48193-1122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-926-6985
Provider Business Mailing Address Fax Number:
734-479-6319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 S MARTHA ST STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANGOLA
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46703-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-668-1000
Provider Business Practice Location Address Fax Number:
260-665-8368
Provider Enumeration Date:
07/01/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCCONNELL
Authorized Official First Name:
JAYSON
Authorized Official Middle Name:
W
Authorized Official Title or Position:
INTERIM DIRECTOR
Authorized Official Telephone Number:
260-668-1000

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0287 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0499867 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000184580 . This is a "PIN FOR BCBS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 590164357 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 100281370A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".