Provider Demographics
NPI:1780635979
Name:VILLAGE OF NEWBURGH HEIGHTS
Entity Type:Organization
Organization Name:VILLAGE OF NEWBURGH HEIGHTS
Other - Org Name:VILLAGE OF NEWBURGH HEIGHTS FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-841-6437
Mailing Address - Street 1:4000 WASHINGTON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3248
Mailing Address - Country:US
Mailing Address - Phone:216-641-2717
Mailing Address - Fax:216-641-2715
Practice Address - Street 1:4071 E 49TH ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44105-3203
Practice Address - Country:US
Practice Address - Phone:216-641-8437
Practice Address - Fax:216-641-2121
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VILLAGE OF NEWBURGH HEIGHTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-13
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0501000341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000231878OtherBCBS
OH590010885OtherRR MEDICARE
OH2250157Medicaid
OH2250157Medicaid
OH=========-002OtherMEDMUTUAL