Provider Demographics
NPI:1053303578
Name:SANDUSKY CITY OFFICE OF TREASURER
Entity Type:Organization
Organization Name:SANDUSKY CITY OFFICE OF TREASURER
Other - Org Name:CITY OF SANDUSKY AMBULANCE CITY OF SANDUSKY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:WIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-627-5888
Mailing Address - Street 1:222 MEIGS ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-2835
Mailing Address - Country:US
Mailing Address - Phone:419-627-5888
Mailing Address - Fax:419-627-5892
Practice Address - Street 1:600 W MARKET ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-2412
Practice Address - Country:US
Practice Address - Phone:419-627-5848
Practice Address - Fax:419-627-5820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0467829Medicaid
OH000000156071OtherANTHEM BLUE CROSS
590000184OtherRAILROAD MEDICARE
MI4745457Medicaid
OH000000156071OtherANTHEM BLUE CROSS