Provider Demographics
NPI:1093768152
Name:CITY OF BEDFORD HEIGHTS
Entity Type:Organization
Organization Name:CITY OF BEDFORD HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-786-3251
Mailing Address - Street 1:PO BOX 21727
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-0727
Mailing Address - Country:US
Mailing Address - Phone:440-605-9117
Mailing Address - Fax:440-442-4443
Practice Address - Street 1:5661 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-2558
Practice Address - Country:US
Practice Address - Phone:440-786-3251
Practice Address - Fax:440-786-3224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000156039OtherANTHEM BCBS
OH0973031Medicaid
OH590008638OtherRAILROAD MEDICARE
OH000000156039OtherANTHEM BCBS
OH9267211Medicare ID - Type UnspecifiedMEDICARE