Provider Demographics
NPI:1992788533
Name:PERRYSBURG CITY OFFICE OF CORPORATION CLERK
Entity type:Organization
Organization Name:PERRYSBURG CITY OFFICE OF CORPORATION CLERK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANANTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-872-8026
Mailing Address - Street 1:201 W INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1525
Mailing Address - Country:US
Mailing Address - Phone:419-872-8025
Mailing Address - Fax:419-872-8079
Practice Address - Street 1:26100 FORT MEIGS RD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1145
Practice Address - Country:US
Practice Address - Phone:419-872-8025
Practice Address - Fax:419-872-8079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10041OtherPARAMOUNT HEALTHCARE
OH0307966Medicaid
OH590175518OtherRR MEDICARE
OH356089400OtherUS DEPT OF LABOR
OH=========00OtherBUREAU OF WORKERS COMP
OH=========00OtherBUREAU OF WORKERS COMP