Provider Demographics
NPI:1922097427
Name:CITY OF RIVERSIDE
Entity Type:Organization
Organization Name:CITY OF RIVERSIDE
Other - Org Name:RIVERSIDE FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-233-1801
Mailing Address - Street 1:PO BOX 73648
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0002
Mailing Address - Country:US
Mailing Address - Phone:855-626-9660
Mailing Address - Fax:833-953-0588
Practice Address - Street 1:1791 HARSHMAN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-5017
Practice Address - Country:US
Practice Address - Phone:937-233-6212
Practice Address - Fax:937-252-8052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHFCY.020328700-13341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH590009041OtherRAILROAD
OH590009041OtherRAILROAD MEDICARE
OH0112569Medicaid
OHANTHEMOther000000021566