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Organization

CITY OF LEBANON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RYAN DIPZINSKI (CHIEF)
(513) 228-3852
Entity
Organization

Contact information

Practice address
601 N BROADWAY ST, LEBANON, OH 45036-1723
(513) 228-3852
Mailing address
PO BOX 392907, PITTSBURGH, PA 15251-9907
(800) 962-1484

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000021401
ANTHEM BC/BS
05
0145962
OH
01
590001578
RAILROAD MEDICARE
Enumeration date
06/01/2005
Last updated
05/16/2023
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