Provider Demographics
NPI:1588706808
Name:CITY OF GARFIELD HEIGHTS
Entity type:Organization
Organization Name:CITY OF GARFIELD HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:LONGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-475-1100
Mailing Address - Street 1:5407 TURNEY RD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-3203
Mailing Address - Country:US
Mailing Address - Phone:216-475-1503
Mailing Address - Fax:216-475-3807
Practice Address - Street 1:5407 TURNEY RD
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-3203
Practice Address - Country:US
Practice Address - Phone:216-475-1503
Practice Address - Fax:216-475-3807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0791853Medicaid
OH000000155979OtherANTHEM CMIC
OH0791853Medicaid
OH9237471Medicare PIN
OH=========001OtherMEDICAL MUTUAL