MEDICARE: CITY OF BRECKSVILLE

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

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

General Provider Information

NPI Number	:	1841528478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF BRECKSVILLE

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	:	850 BRAINARD RD STE 1F
Second Line	:	C/O GREAT LAKES BILLING
City	:	CLEVELAND
State	:	OH
Zip	:	44143-3145
Country	:	US
Telephone Number	:	440-605-9117
Fax Number	:	440-442-4443

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	VIRGINIA PRICE
Credential	:	CPA
Telephone Number	:	440-526-2608

Provider Enumeration Date	:	11/19/2009
Last Update Date	:	11/06/2013

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Directions to “CITY OF BRECKSVILLE ” Practice Location

Language	Start Address	Practice Location

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