MEDICARE: CITY OF WYOMING

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	590011917	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000021412	OTHER	OH	ANTHEM BCBS
3	153650001	OTHER	OH	CARESOURCE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609865476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF WYOMING

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	:	600 GROVE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2762
Country	:	US
Telephone Number	:	513-821-6836
Fax Number	:	513-821-8609

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	JEREMIAH CAUDILL
Credential	:
Telephone Number	:	513-821-6836

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	05/21/2024

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Directions to “CITY OF WYOMING ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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