MEDICARE: CITY OF BROOKVILLE

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
2	590015168	OTHER	OH	RAILROAD MEDICARE

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
3	000000208071	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1316939523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF BROOKVILLE

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	:	775 E UPPER LEWISBURG SALEM RD
Second Line	:
City	:	BROOKVILLE
State	:	OH
Zip	:	45309-0001
Country	:	US
Telephone Number	:	937-833-2345
Fax Number	:	937-833-4051

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	RONALD FLETCHER
Credential	:
Telephone Number	:	937-833-2345

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	04/16/2024

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Directions to “CITY OF BROOKVILLE ” Practice Location

Language	Start Address	Practice Location

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