=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790847101
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY OF PORTSMOUTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2006
-----------------------------------------------------
Last Update Date | 04/27/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 605 WASHINGTON ST
-----------------------------------------------------
City | PORTSMOUTH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45662-3919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-353-8863
-----------------------------------------------------
Fax | 740-354-7854
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 605 WASHINGTON ST
-----------------------------------------------------
City | PORTSMOUTH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45662-3919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-353-8863
-----------------------------------------------------
Fax | 740-355-0279
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING COORDINATOR
-----------------------------------------------------
Name | MRS. LISA MEYERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 740-353-8863
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------