Provider Demographics
NPI:1184614729
Name:CITY OF WEST CARROLLTON
Entity type:Organization
Organization Name:CITY OF WEST CARROLLTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-847-4645
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 1:125 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45449
Practice Address - Country:US
Practice Address - Phone:937-847-4645
Practice Address - Fax:937-847-4644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherTRICARE 4 LIFE
OH2097163Medicaid
OH000000021411OtherANTHEM BCBS
OH=========OtherMEDICAL MUTUAL OF OHIO
OH287940001OtherCARESOURCE
OH=========OtherBUREAU OF WORKERS COMP
OH590012556OtherRAILROAD MEDICARE
OH2097163Medicaid