Healthcare Provider Details

I. General information

NPI: 1487649745
Provider Name (Legal Business Name): CITY OF EATON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 11/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 N MAPLE ST
EATON OH
45320-1830
US

IV. Provider business mailing address

PO BOX 645198
CINCINNATI OH
45264-5198
US

V. Phone/Fax

Practice location:
  • Phone: 937-456-5310
  • Fax: 937-456-5311
Mailing address:
  • Phone: 866-631-2658
  • Fax: 937-291-2971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number02035880013
License Number StateOH

VIII. Authorized Official

Name: BRIAN SMITH
Title or Position: FIRE CHIEF
Credential:
Phone: 937-456-5310