Village of Huntsville

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

Legal business name

VILLAGE OF HUNTSVILLE

Doing business as

Huntsville Emergency Squad

Practice address

6740 Wishart St
Huntsville, OH 43324-9619

Phone

(937) 686-4294

Fax

(937) 686-4329

NPI assigned

Mar 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Phyllis J Hall

Title

EMS Clerk

Phone

(937) 686-4294

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Huntsville Emergency Squad Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982720462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6740 WISHART ST",
            "city": "HUNTSVILLE",
            "state": "OH",
            "postal_code": "433249619",
            "telephone_number": "937-686-4294",
            "fax_number": "937-686-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6740 WISHART ST",
            "city": "HUNTSVILLE",
            "state": "OH",
            "postal_code": "433249619",
            "telephone_number": "937-686-4294",
            "fax_number": "937-686-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF HUNTSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EMS CLERK",
        "authorized_official_telephone_number": "937-686-4294"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0879401",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntsville Emergency Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Connie Sue Pratt, LPN
• Quickaccess Home Health Care Services LLC (Quickaccess Care)
• Melissa M Rollins
• Brandi Scott
• Stacy Elizabeth Staley-Kinney
• Katherine Zeller

• Emergency Care Clinic/Center in Huntsville, OH
• Providers in Huntsville, OH by specialty
• Emergency Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.