Provider Demographics
NPI:1861489411
Name:VILLAGE OF LOCKLAND
Entity Type:Organization
Organization Name:VILLAGE OF LOCKLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-761-2751
Mailing Address - Street 1:PO BOX 392907
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9907
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:101 N COOPER AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-3008
Practice Address - Country:US
Practice Address - Phone:513-761-2751
Practice Address - Fax:513-761-4948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0492953Medicaid
OH000000021615OtherANTHEM BCBS
OH590000989OtherRAILROAD MEDICARE
OH122540001OtherCARESOURCE
OH590000989OtherRAILROAD MEDICARE
OH=========00OtherBUREAU OF WORKERS COMP
OH=========OtherTRICARE 4 LIFE
OH9278091Medicare PIN