Provider Demographics
NPI:1356375232
Name:CITY OF FAIRLAWN
Entity type:Organization
Organization Name:CITY OF FAIRLAWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-668-9560
Mailing Address - Street 1:3487 S SMITH RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3007
Mailing Address - Country:US
Mailing Address - Phone:330-668-9500
Mailing Address - Fax:330-668-9565
Practice Address - Street 1:3525 S SMITH RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3077
Practice Address - Country:US
Practice Address - Phone:330-668-9540
Practice Address - Fax:330-668-9545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FA9223391Medicare ID - Type Unspecified