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Organization

CITY OF CORTLAND

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVE REA (CHIEF)
(330) 637-2891
Entity
Organization

Contact information

Practice address
194 LATTIN ST, CORTLAND, OH 44410-1029
(800) 962-1484
(513) 772-4464
Mailing address
PO BOX 392907, PITTSBURGH, PA 15251-9907
(800) 962-1484
(513) 772-4464

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000156044
ANTHEM
05
000000186476
OH
01
001746600
HIGHMARK BLUE SHIELD
05
0176385
OH
Enumeration date
12/15/2006
Last updated
05/21/2024
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