Organization
VILLAGE OF GOLF MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG BALLMAN (FIRE CHIEF)
(513) 531-2022
Entity
Organization
Contact information
Practice address
6450 WIEHE RD, CINCINNATI, OH 45237-4216
(800) 962-1484
(513) 772-4464
Mailing address
10361 SPARTAN DR, CINCINNATI, OH 45215-1220
(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
—
000000221798
ANTHEM
OH
05
—
2333764
—
OH
01
—
590015177
RAILROAD MEDICARE
OH
Enumeration date
06/24/2006
Last updated
11/10/2016
Update your record
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