MEDICARE: VILLAGE OF LINCOLN HEIGHTS

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	341600000X	Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590009512	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000000021478	OTHER	OH	ANTHEM BCBS
3	104640001	OTHER	OH	CARESOURCE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134115298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF LINCOLN HEIGHTS

Provider Business Mailing Address
First Line	:	10361 SPARTAN DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-1220
Country	:	US
Telephone Number	:	800-962-1484
Fax Number	:	513-772-4464

Provider Business Practice Location Address
First Line	:	1201 STEFFEN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2334
Country	:	US
Telephone Number	:	513-733-0963
Fax Number	:	513-733-4190

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	VERNELL ELLIOTT
Credential	:
Telephone Number	:	513-733-0963

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	11/10/2016

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Directions to “VILLAGE OF LINCOLN HEIGHTS ” Practice Location

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