Organization
CITY OF WICKLIFFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER GROSSMAN (CHIEF)
(440) 943-7177
Entity
Organization
Contact information
Practice address
29885 EUCLID AVE, WICKLIFFE, OH 44092-1863
(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
—
000000372720
ANTHEM
OH
05
—
2610286
—
OH
01
—
P00224868
RAILROAD MEDICARE
OH
Enumeration date
07/09/2006
Last updated
05/27/2025
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