MEDICARE: VILLAGE OF CUYAHOGA 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
2	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000352444	OTHER	OH	ANTHEM BCBS

General Provider Information

NPI Number	:	1134140205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF CUYAHOGA HEIGHTS

Provider Business Mailing Address
First Line	:	PO BOX 21727
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44121-0727
Country	:	US
Telephone Number	:	440-605-9117
Fax Number	:	440-442-4443

Provider Business Practice Location Address
First Line	:	4863 E 71ST ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44125-1023
Country	:	US
Telephone Number	:	216-641-7020
Fax Number	:	216-641-8485

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	MICHAEL SUHY
Credential	:
Telephone Number	:	216-641-7020

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	03/31/2020

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Directions to “VILLAGE OF CUYAHOGA HEIGHTS ” Practice Location

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