MEDICARE: MAYFIELD HEIGHTS CITY

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
2	341600000X	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

General Provider Information

NPI Number	:	1265762710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYFIELD HEIGHTS CITY

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	:	6154 MAYFIELD RD
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-3207
Country	:	US
Telephone Number	:	440-442-2626
Fax Number	:	440-442-0232

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	BRUCE EDWARD ELLIOTT
Credential	:
Telephone Number	:	440-442-2626

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	10/08/2019

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Directions to “MAYFIELD HEIGHTS CITY ” Practice Location

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