Healthcare Provider Details

I. General information

NPI: 1902800667
Provider Name (Legal Business Name): CITY OF BRUNSWICK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4383 CENTER RD
BRUNSWICK OH
44212-3420
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251-9907
US

V. Phone/Fax

Practice location:
  • Phone: 330-225-2780
  • Fax: 330-273-8070
Mailing address:
  • Phone: 800-962-1484
  • Fax: 513-772-4464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number02-367650
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number02-367651
License Number StateOH

VIII. Authorized Official

Name: MR. CARL DEFOREST
Title or Position: CITY MANAGER
Credential:
Phone: 330-225-2780