Provider Demographics
NPI:1487841920
Name:GIRARD CITY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:GIRARD CITY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:ENYEART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-545-6048
Mailing Address - Street 1:100 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-2598
Mailing Address - Country:US
Mailing Address - Phone:330-545-6048
Mailing Address - Fax:330-539-7209
Practice Address - Street 1:100 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-2598
Practice Address - Country:US
Practice Address - Phone:330-545-6048
Practice Address - Fax:330-539-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0364225OtherBCMH
OHNON-PAR OH/CMSRATEOtherANTHEM SENIOR ADVANTAGE
OH0872766Medicaid
OH0872766Medicaid