Organization
CITY OF WYOMING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMIAH CAUDILL (FINANCE DIRECTOR)
(513) 821-6836
Entity
Organization
Contact information
Practice address
600 GROVE AVE, CINCINNATI, OH 45215-2762
(513) 821-6836
(513) 821-8609
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
—
000000021412
ANTHEM BCBS
OH
01
—
153650001
CARESOURCE
OH
05
—
2089092
—
OH
01
—
590011917
RAILROAD MEDICARE
OH
Enumeration date
10/14/2005
Last updated
05/21/2024
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