Provider Demographics
NPI:1386780252
Name:CITY OF RAVENNA
Entity type:Organization
Organization Name:CITY OF RAVENNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:POLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-297-5738
Mailing Address - Street 1:210 PARK WAY
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-2907
Mailing Address - Country:US
Mailing Address - Phone:330-297-5738
Mailing Address - Fax:330-296-1331
Practice Address - Street 1:214 PARK WAY
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-2906
Practice Address - Country:US
Practice Address - Phone:330-297-5738
Practice Address - Fax:330-296-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0431858Medicaid
OH9174821Medicare PIN