=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316939523
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY OF BROOKVILLE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2005
-----------------------------------------------------
Last Update Date | 04/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 775 E UPPER LEWISBURG SALEM RD
-----------------------------------------------------
City | BROOKVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45309-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-833-2345
-----------------------------------------------------
Fax | 937-833-4051
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 392907
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15251-9907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-962-1484
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FIRE CHIEF
-----------------------------------------------------
Name | RONALD FLETCHER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 937-833-2345
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------