Provider Demographics
NPI:1356638498
Name:CITY OF GERMANTOWN
Entity Type:Organization
Organization Name:CITY OF GERMANTOWN
Other - Org Name:GERMANTOWN FIRE/EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:GILLELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-855-7255
Mailing Address - Street 1:PO BOX 637473
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7473
Mailing Address - Country:US
Mailing Address - Phone:855-626-9660
Mailing Address - Fax:833-953-0588
Practice Address - Street 1:75 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:OH
Practice Address - Zip Code:45327-1244
Practice Address - Country:US
Practice Address - Phone:937-855-7255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020312750341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0053462Medicaid
OHP00997369OtherRAILROAD MEDICARE
OH000000722622OtherANTHEM
OHH017590Medicare PIN