Provider Demographics
NPI:1487724233
Name:VILLAGE OF MINGO JUNCTION
Entity type:Organization
Organization Name:VILLAGE OF MINGO JUNCTION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-535-9165
Mailing Address - Street 1:836 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1407
Mailing Address - Country:US
Mailing Address - Phone:304-521-1576
Mailing Address - Fax:304-521-1576
Practice Address - Street 1:501 COMMERCIAL STREET
Practice Address - Street 2:
Practice Address - City:MINGO JUNCTION
Practice Address - State:OH
Practice Address - Zip Code:43938-1233
Practice Address - Country:US
Practice Address - Phone:740-535-9165
Practice Address - Fax:740-535-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005844685OtherAETNA
000000155999OtherANTHEM
OH0448466Medicaid
OH9178131Medicare UPIN