Provider Demographics
NPI:1376696740
Name:CITY OF STREETSBORO
Entity Type:Organization
Organization Name:CITY OF STREETSBORO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:REINHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-626-4664
Mailing Address - Street 1:9184 STATE ROUTE 43
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241
Mailing Address - Country:US
Mailing Address - Phone:330-626-4664
Mailing Address - Fax:330-626-5918
Practice Address - Street 1:9184 STATE ROUTE 43
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241
Practice Address - Country:US
Practice Address - Phone:330-626-4664
Practice Address - Fax:330-626-5918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0245872Medicaid
OH9138301Medicare ID - Type Unspecified