Provider Demographics
NPI:1417989997
Name:VILLAGE OF FAIRPORT HARBOR
Entity Type:Organization
Organization Name:VILLAGE OF FAIRPORT HARBOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHIEF
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-352-3620
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 1:220 3RD ST
Practice Address - Street 2:
Practice Address - City:FAIRPORT HARBOR
Practice Address - State:OH
Practice Address - Zip Code:44077-5822
Practice Address - Country:US
Practice Address - Phone:800-962-1484
Practice Address - Fax:513-772-4464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH590015592OtherRAILROAD MEDICARE
OH000000280550OtherANTHEM
OH2384870Medicaid
OH=========OtherTRICARE 4 LIFE
OH=========00OtherBUREAU OF WORKERS COMP
OH590015592OtherRAILROAD MEDICARE
OH=========OtherTRICARE 4 LIFE