MEDICARE: CITY OF WEST CARROLLTON

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
7	590012556	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	=========	OTHER	OH	TRICARE 4 LIFE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000021411	OTHER	OH	ANTHEM BCBS
4	=========	OTHER	OH	MEDICAL MUTUAL OF OHIO
5	287940001	OTHER	OH	CARESOURCE
6	=========	OTHER	OH	BUREAU OF WORKERS COMP

General Provider Information

NPI Number	:	1184614729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF WEST CARROLLTON

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	:	513-772-4464

Provider Business Practice Location Address
First Line	:	125 W CENTRAL AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449
Country	:	US
Telephone Number	:	937-847-4645
Fax Number	:	937-847-4644

Authorized Official
Title or Position	:	CHIEF
Name	:	CHRIS BARNETT
Credential	:
Telephone Number	:	937-847-4645

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	05/29/2024

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Directions to “CITY OF WEST CARROLLTON ” Practice Location

Language	Start Address	Practice Location

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