Provider Demographics
NPI:1033202189
Name:CITY OF EAST CLEVELAND
Entity Type:Organization
Organization Name:CITY OF EAST CLEVELAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-681-2319
Mailing Address - Street 1:1822 MARLOES AVE
Mailing Address - Street 2:
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-3922
Mailing Address - Country:US
Mailing Address - Phone:216-681-2319
Mailing Address - Fax:216-681-2098
Practice Address - Street 1:14340 EUCLID AVE
Practice Address - Street 2:ROOM 108
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-3402
Practice Address - Country:US
Practice Address - Phone:216-681-2319
Practice Address - Fax:216-681-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2299169Medicaid
OH9318381Medicare PIN