Healthcare Provider Details

I. General information

NPI: 1982604500
Provider Name (Legal Business Name): CITY OF XENIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E MAIN ST
XENIA OH
45385-3218
US

IV. Provider business mailing address

PO BOX 2030
MOUNT VERNON OH
43050-7230
US

V. Phone/Fax

Practice location:
  • Phone: 937-376-7280
  • Fax:
Mailing address:
  • Phone: 866-631-4551
  • Fax: 937-291-2971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number02-0299450
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. BRENT W MERRIMAN
Title or Position: CITY MANAGER/SAFETY DIRECTOR
Credential:
Phone: 937-376-7231