Provider Demographics
NPI:1134115298
Name:VILLAGE OF LINCOLN HEIGHTS
Entity Type:Organization
Organization Name:VILLAGE OF LINCOLN HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:VERNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-733-0963
Mailing Address - Street 1:10361 SPARTAN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1220
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:1201 STEFFEN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-2334
Practice Address - Country:US
Practice Address - Phone:513-733-0963
Practice Address - Fax:513-733-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH590009512OtherRAILROAD MEDICARE
OH000000021478OtherANTHEM BCBS
OH104640001OtherCARESOURCE
OH0147353Medicaid
OH104640001OtherCARESOURCE
OH=========OtherTRICARE 4 LIFE
OH=========002OtherMEDICAL MUTUAL OF OHIO
OH=========00OtherBUREAU OF WORKERS COMP