Provider Demographics
NPI:1487649745
Name:CITY OF EATON
Entity Type:Organization
Organization Name:CITY OF EATON
Other - Org Name:CITY OF EATON FIRE & EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-456-5310
Mailing Address - Street 1:PO BOX 645198
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-5198
Mailing Address - Country:US
Mailing Address - Phone:866-631-2658
Mailing Address - Fax:937-291-2971
Practice Address - Street 1:328 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-1830
Practice Address - Country:US
Practice Address - Phone:937-456-5310
Practice Address - Fax:937-456-5311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02035880013341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00381347OtherRAILROAD MEDICARE
OH0297496Medicaid
OH000000021439OtherANTHEM
OHP00381347OtherRAILROAD MEDICARE