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Organization
CITY OF DAYTON
Active
Organization
CITY OF DAYTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY PAYNE II (DIRECTOR)
(937) 333-4504
Entity
Organization
Contact information
Practice address
300 N MAIN ST, DAYTON, OH 45402-1208
(888) 449-8112
(888) 965-4620
Mailing address
PO BOX 632458, CINCINNATI, OH 45263-2458
(888) 449-8112
(888) 965-4620
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000021399
ANTHEM
OH
05
—
0978330
—
OH
01
—
590008510
RAILROAD MEDICARE
OH
Enumeration date
08/02/2005
Last updated
02/12/2019
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