Provider Demographics
NPI:1861492472
Name:CITY OF SPRINGFIELD
Entity Type:Organization
Organization Name:CITY OF SPRINGFIELD
Other - Org Name:SPRINGFIELD FIRE RESCUE DIVISION
Other - Org Type:Other Name
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-324-7305
Mailing Address - Street 1:76 E HIGH ST
Mailing Address - Street 2:4TH FLOOR TREASURY
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-1214
Mailing Address - Country:US
Mailing Address - Phone:937-424-3701
Mailing Address - Fax:937-291-2971
Practice Address - Street 1:350 N FOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2537
Practice Address - Country:US
Practice Address - Phone:937-324-7610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0303950341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2311859Medicaid
OH000000218700OtherANTHEM
OH590014950OtherRAILROAD MEDICARE
OH9318501Medicare PIN