1003047390 NPI number — CITY OF WESTERVILLE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003047390 NPI number — CITY OF WESTERVILLE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF WESTERVILLE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WESTERVILLE DIVISION OF FIRE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003047390
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 78000 DEPT 781700
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48278-1700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
885-626-9660
Provider Business Mailing Address Fax Number:
833-953-0588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTERVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43081-1436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-901-6606
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/04/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
614-901-6606

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  02-0299250 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000630143 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 3019674 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00800953 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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