Provider Demographics
NPI:1609865476
Name:CITY OF WYOMING
Entity Type:Organization
Organization Name:CITY OF WYOMING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:RIELAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-821-6836
Mailing Address - Street 1:PO BOX 621005
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45262-1005
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:800 OAK AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-2720
Practice Address - Country:US
Practice Address - Phone:513-821-6836
Practice Address - Fax:513-821-8609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH153650001OtherCARESOURCE
OH590011917OtherRAILROAD MEDICARE
OH000000021412OtherANTHEM BCBS
OH2089092Medicaid
OH153650001OtherCARESOURCE
OH590011917OtherRAILROAD MEDICARE
OH=========00OtherBUREAU OF WORKERS COMP
OH153650001OtherCARESOURCE