Provider Demographics
NPI:1740224823
Name:CITY OF ALLIANCE
Entity Type:Organization
Organization Name:CITY OF ALLIANCE
Other - Org Name:ALLIANCE CITY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:M
Authorized Official - Last Name:FLINT
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:330-821-7373
Mailing Address - Street 1:537 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-2514
Mailing Address - Country:US
Mailing Address - Phone:330-821-7373
Mailing Address - Fax:330-821-9517
Practice Address - Street 1:537 E MARKET ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-2514
Practice Address - Country:US
Practice Address - Phone:330-821-7373
Practice Address - Fax:330-821-9517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0672857Medicaid
OH0672857Medicaid