MEDICARE: SYCAMORE TOWNSHIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	590010315	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	272130001	OTHER	OH	CARESOURCE
2	000000021593	OTHER	OH	ANTHEM BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265429039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYCAMORE TOWNSHIP

Provider Business Mailing Address
First Line	:	PO BOX 392907
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9907
Country	:	US
Telephone Number	:	800-962-1484
Fax Number	:	513-772-4464

Provider Business Practice Location Address
First Line	:	8540 KENWOOD RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2010
Country	:	US
Telephone Number	:	513-792-8565
Fax Number	:	513-792-8564

Authorized Official
Title or Position	:	ASST FIRE CHIEF
Name	:	KELBY THORESON
Credential	:
Telephone Number	:	513-792-8565

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	04/21/2026

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Directions to “SYCAMORE TOWNSHIP ” Practice Location

Language	Start Address	Practice Location

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