MEDICARE: CITY OF BRUNSWICK

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	02-367650	OH
2	3416L0300X	Land Ambulance	02-367651	OH
3	341600000X	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

General Provider Information

NPI Number	:	1902800667
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF BRUNSWICK

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	:	4383 CENTER RD
Second Line	:
City	:	BRUNSWICK
State	:	OH
Zip	:	44212-3420
Country	:	US
Telephone Number	:	330-225-2780
Fax Number	:	330-273-8070

Authorized Official
Title or Position	:	CITY MANAGER
Name	:	MR. CARL DEFOREST
Credential	:
Telephone Number	:	330-225-2780

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	05/17/2024

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Directions to “CITY OF BRUNSWICK ” Practice Location

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