MEDICARE: CITY OF OLMSTED FALLS

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	590012772	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000156010	OTHER	OH	ANTHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558314807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF OLMSTED FALLS

Provider Business Mailing Address
First Line	:	PO BOX 951007
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0193
Country	:	US
Telephone Number	:	440-605-9117
Fax Number	:	440-442-4443

Provider Business Practice Location Address
First Line	:	26100 BAGLEY RD
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-1812
Country	:	US
Telephone Number	:	440-235-5551
Fax Number	:	440-235-8900

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	MR. BRIAN GILLETTE
Credential	:
Telephone Number	:	440-235-5551

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	01/12/2017

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Directions to “CITY OF OLMSTED FALLS ” Practice Location

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