Provider Demographics
NPI:1952446007
Name:CITY OF LYNDHURST
Entity Type:Organization
Organization Name:CITY OF LYNDHURST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:TELZROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-473-5139
Mailing Address - Street 1:5301 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2451
Mailing Address - Country:US
Mailing Address - Phone:440-473-5139
Mailing Address - Fax:440-646-9562
Practice Address - Street 1:5301 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2451
Practice Address - Country:US
Practice Address - Phone:440-473-5139
Practice Address - Fax:440-646-9562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2638024Medicaid
OH2638024Medicaid