Provider Demographics
NPI:1235138074
Name:CITY OF ERLANGER
Entity type:Organization
Organization Name:CITY OF ERLANGER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GODSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-727-7942
Mailing Address - Street 1:PO BOX 392907
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9907
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:515 GRAVES AVE
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-3301
Practice Address - Country:US
Practice Address - Phone:859-727-7942
Practice Address - Fax:859-727-7956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1512341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY590009376OtherRAILROAD MEDICARE
KY000000039202OtherANTHEM
KY00000117297OtherCHA
OH2435903Medicaid
IN200418420AMedicaid
KY55059109Medicaid
KY56008394Medicaid
KY56008394Medicaid