Provider Demographics
NPI:1225094022
Name:CITY OF MOUNT VERNON CITY AUDITOR
Entity Type:Organization
Organization Name:CITY OF MOUNT VERNON CITY AUDITOR
Other - Org Name:CITY OF MOUNT VERNON FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:SAFETY-SERVICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:DZIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-393-9529
Mailing Address - Street 1:PO BOX 2015
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-7215
Mailing Address - Country:US
Mailing Address - Phone:855-626-9660
Mailing Address - Fax:833-953-0588
Practice Address - Street 1:200 W. GAMBIER STREET
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-2424
Practice Address - Country:US
Practice Address - Phone:740-393-9515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0358100341600000X
OHFCY.020358100-13341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2673110Medicaid
OH000000476763OtherANTHEM
OHP00336343OtherRAILROAD MEDICARE
OHP00336343OtherRAILROAD MEDICARE