MEDICARE: CITY OF EUCLID

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	18035	OH

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	:	1861477812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF EUCLID

Provider Business Mailing Address
First Line	:	585 E 222ND ST
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44123-2029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	585 E 222ND ST
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44123-2029
Country	:	US
Telephone Number	:	216-289-2700
Fax Number	:

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	JACK JOHNSON
Credential	:
Telephone Number	:	216-289-2700

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	08/14/2007

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Directions to “CITY OF EUCLID ” Practice Location

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