Organization
CITY OF MENTOR ON THE LAKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PECHATSKO (CHIEF)
(440) 257-7223
Entity
Organization
Contact information
Practice address
5860 ANDREWS RD, MENTOR ON THE LAKE, OH 44060-2827
(440) 257-7216
(440) 257-2766
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
—
000000155996
ANTHEM BCBS
OH
05
—
2096486
—
OH
01
—
590013209
RAILROAD MEDICARE
OH
Enumeration date
09/23/2005
Last updated
09/01/2021
Update your record
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