Provider Demographics
NPI:1831199041
Name:CITY OF HILLSBORO
Entity type:Organization
Organization Name:CITY OF HILLSBORO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-393-2902
Mailing Address - Street 1:PO BOX 643299
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-0307
Mailing Address - Country:US
Mailing Address - Phone:937-291-7850
Mailing Address - Fax:937-291-2971
Practice Address - Street 1:130 N HIGH ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-1152
Practice Address - Country:US
Practice Address - Phone:937-393-5791
Practice Address - Fax:937-393-3691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0321262Medicaid
OH000000021459OtherANTHEM
OH9151232Medicare PIN