Provider Demographics
NPI:1790847101
Name:CITY OF PORTSMOUTH
Entity Type:Organization
Organization Name:CITY OF PORTSMOUTH
Other - Org Name:PORTSMOUTH CITY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-353-8863
Mailing Address - Street 1:605 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-3919
Mailing Address - Country:US
Mailing Address - Phone:740-353-8863
Mailing Address - Fax:740-355-0279
Practice Address - Street 1:605 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3919
Practice Address - Country:US
Practice Address - Phone:740-353-8863
Practice Address - Fax:740-354-7854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0246700Medicaid
OH600001152OtherMEDICARE RAILROAD ID
OH0246700Medicaid