MEDICARE: OLMSTED TOWNSHIP BOARD OF TRUSTEES

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
2	P00172691	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000273859	OTHER	OH	ANTHEM BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831142199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLMSTED TOWNSHIP BOARD OF TRUSTEES

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	:	26900 COOK RD
Second Line	:
City	:	OLMSTED TWP
State	:	OH
Zip	:	44138-1194
Country	:	US
Telephone Number	:	440-235-3099
Fax Number	:	440-235-3778

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	MR. JOHN RICE
Credential	:
Telephone Number	:	440-235-3099

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	11/06/2013

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Directions to “OLMSTED TOWNSHIP BOARD OF TRUSTEES ” Practice Location

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