Provider Demographics
NPI:1558314807
Name:CITY OF OLMSTED FALLS
Entity Type:Organization
Organization Name:CITY OF OLMSTED FALLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-235-5551
Mailing Address - Street 1:PO BOX 951007
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0193
Mailing Address - Country:US
Mailing Address - Phone:440-605-9117
Mailing Address - Fax:440-442-4443
Practice Address - Street 1:26100 BAGLEY RD
Practice Address - Street 2:
Practice Address - City:OLMSTED FALLS
Practice Address - State:OH
Practice Address - Zip Code:44138-1812
Practice Address - Country:US
Practice Address - Phone:440-235-5551
Practice Address - Fax:440-235-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000156010OtherANTHEM BCBS
OH2367308Medicaid
OH590012772OtherRAILROAD MEDICARE
OH2367308Medicaid
OH2367308Medicaid