MEDICARE: CITY OF HILLSBORO

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000021459	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1831199041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF HILLSBORO

Provider Business Mailing Address
First Line	:	PO BOX 643299
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45264-0307
Country	:	US
Telephone Number	:	937-291-7850
Fax Number	:	937-291-2971

Provider Business Practice Location Address
First Line	:	130 N HIGH ST
Second Line	:
City	:	HILLSBORO
State	:	OH
Zip	:	45133-1152
Country	:	US
Telephone Number	:	937-393-5791
Fax Number	:	937-393-3691

Authorized Official
Title or Position	:	CHIEF
Name	:	JERRY POWELL
Credential	:
Telephone Number	:	937-393-2902

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	03/13/2008

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Directions to “CITY OF HILLSBORO ” Practice Location

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