MEDICARE: CITY OF WILMINGTON

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	3416L0300X	Land Ambulance	020326901	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000289558	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649262460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF WILMINGTON

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	:	46 E SUGARTREE ST
Second Line	:
City	:	WILMINGTON
State	:	OH
Zip	:	45177-2331
Country	:	US
Telephone Number	:	937-382-2244
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	ANDY MASON
Credential	:
Telephone Number	:	937-382-2244

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	05/13/2024

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Directions to “CITY OF WILMINGTON ” Practice Location

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