Provider Demographics
NPI:1700844982
Name:STERLING EMERGENCY SERVICES OF THE MIDWEST, INC
Entity Type:Organization
Organization Name:STERLING EMERGENCY SERVICES OF THE MIDWEST, INC
Other - Org Name:DAYTON ED SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN/PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-805-1300
Mailing Address - Street 1:PO BOX 758705
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-0001
Mailing Address - Country:US
Mailing Address - Phone:904-805-1300
Mailing Address - Fax:904-805-1302
Practice Address - Street 1:1997 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3811
Practice Address - Country:US
Practice Address - Phone:937-439-6000
Practice Address - Fax:904-805-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000291736OtherBLUE CROSS & BLUE SHIELD
OH0321708Medicaid
OH153055800OtherDEPT OF LABOR
OH153055800OtherFL BLACK LUNG
OHDC8485OtherRAIL ROAD MEDICARE
OH=========019OtherCHAMPUS
OH=========12OtherWORK COMP
OH153055800OtherDEPT OF LABOR
OHDC8485OtherRAIL ROAD MEDICARE
OH9345822Medicare PIN