Provider Demographics
NPI:1841528478
Name:CITY OF BRECKSVILLE
Entity type:Organization
Organization Name:CITY OF BRECKSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:440-526-2608
Mailing Address - Street 1:PO BOX 21727
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-0727
Mailing Address - Country:US
Mailing Address - Phone:440-605-9117
Mailing Address - Fax:440-442-4443
Practice Address - Street 1:850 BRAINARD RD STE 1F
Practice Address - Street 2:C/O GREAT LAKES BILLING
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-3145
Practice Address - Country:US
Practice Address - Phone:440-605-9117
Practice Address - Fax:440-442-4443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3048473Medicaid
OH3048473Medicaid