Provider Demographics
NPI:1083621619
Name:CITY OF KENT DIRECTOR OF FINANCE
Entity Type:Organization
Organization Name:CITY OF KENT DIRECTOR OF FINANCE
Other - Org Name:KENT CITY HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-676-7393
Mailing Address - Street 1:320 SOUTH DEPEYSTER
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-7912
Mailing Address - Country:US
Mailing Address - Phone:330-676-7393
Mailing Address - Fax:330-676-7374
Practice Address - Street 1:320 S DEPEYSTER ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-7912
Practice Address - Country:US
Practice Address - Phone:330-676-7393
Practice Address - Fax:330-676-7374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0297398Medicaid
OH0297398Medicaid