MEDICARE: CITY OF BROOKLYN BROOKLYN CITY TOWN HALL

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
2	3416L0300X	Land Ambulance	3416L0300X	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590008421	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	602954700	OTHER	OH	U.S. DEPT. OF LABOR

General Provider Information

NPI Number	:	1720114739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF BROOKLYN BROOKLYN CITY TOWN HALL

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	:	8400 MEMPHIS AVE
Second Line	:
City	:	BROOKLYN
State	:	OH
Zip	:	44144-2156
Country	:	US
Telephone Number	:	216-749-1212
Fax Number	:	216-351-0760

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	MR. JOSEPH F ZEMEK
Credential	:
Telephone Number	:	216-635-4226

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	04/29/2013

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Directions to “CITY OF BROOKLYN BROOKLYN CITY TOWN HALL ” Practice Location

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