MEDICARE: CITY OF EAST PALESTINE OFFICE OF TREASURER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	02-0320450-09809	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	590004802	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000155975	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003812983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF EAST PALESTINE OFFICE OF TREASURER

Provider Business Mailing Address
First Line	:	PO BOX 392907
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9907
Country	:	US
Telephone Number	:	800-962-1484
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 E MAIN ST
Second Line	:
City	:	EAST PALESTINE
State	:	OH
Zip	:	44413-2009
Country	:	US
Telephone Number	:	330-426-4341
Fax Number	:	330-426-7063

Authorized Official
Title or Position	:	VILLAGE MANAGER
Name	:	ANTONIO DIAZ-GUY
Credential	:
Telephone Number	:	330-426-4367

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	03/11/2025

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