Provider Demographics
NPI:1174651921
Name:CITY OF MIDDLEBURG HTS
Entity Type:Organization
Organization Name:CITY OF MIDDLEBURG HTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BENEDICT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-243-1313
Mailing Address - Street 1:15800 BAGLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4834
Mailing Address - Country:US
Mailing Address - Phone:440-243-1313
Mailing Address - Fax:440-243-4654
Practice Address - Street 1:15800 BAGLEY RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4834
Practice Address - Country:US
Practice Address - Phone:440-243-1313
Practice Address - Fax:440-243-4654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0887974Medicaid
OH0887974Medicaid