Healthcare Provider Details
I. General information
NPI: 1578651246
Provider Name (Legal Business Name): CITY OF LIMA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2006
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
433 S MAIN ST
LIMA OH
45804-1237
US
IV. Provider business mailing address
L-3328
COLUMBUS OH
43260-0001
US
V. Phone/Fax
- Phone: 419-221-5160
- Fax: 419-221-5154
- Phone: 419-221-5160
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 020304650 |
| License Number State | OH |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | P00847479 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | RAILROAD MEDICARE |
| # 2 | |
| Identifier | 000000638051 |
| Identifier Type | OTHER |
| Identifier State | OH |
| Identifier Issuer | ANTHEM |
| # 3 | |
| Identifier | 3021983 |
| Identifier Type | MEDICAID |
| Identifier State | OH |
| Identifier Issuer | |
VIII. Authorized Official
Name:
BRIAN
STEWART
Title or Position: DEPUTY FIRE CHIEF
Credential:
Phone: 419-221-5166