Provider Demographics
NPI:1558523506
Name:CITY OF SHARONVILLE
Entity Type:Organization
Organization Name:CITY OF SHARONVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-563-0252
Mailing Address - Street 1:11637 CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-2803
Mailing Address - Country:US
Mailing Address - Phone:513-563-0252
Mailing Address - Fax:513-483-6122
Practice Address - Street 1:11210 READING RD
Practice Address - Street 2:
Practice Address - City:SHARONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45241-2239
Practice Address - Country:US
Practice Address - Phone:513-563-0252
Practice Address - Fax:513-483-2803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPENDINGMedicaid
OHPENDINGMedicare PIN