Provider Demographics
NPI:1437829694
Name:CITY OF PONTIAC
Entity Type:Organization
Organization Name:CITY OF PONTIAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:KARLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-848-0942
Mailing Address - Street 1:413 N. MILL ST.
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:IL
Mailing Address - Zip Code:61764-1813
Mailing Address - Country:US
Mailing Address - Phone:815-842-3225
Mailing Address - Fax:815-842-6567
Practice Address - Street 1:115 W. HOWARD ST.
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:IL
Practice Address - Zip Code:61764-1819
Practice Address - Country:US
Practice Address - Phone:815-844-3396
Practice Address - Fax:815-842-3885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport