Provider Demographics
NPI:1205828902
Name:CITY OF MIDDLETOWN
Entity type:Organization
Organization Name:CITY OF MIDDLETOWN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-425-7832
Mailing Address - Street 1:PO BOX 634475
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-4475
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:1830 YANKEE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5941
Practice Address - Country:US
Practice Address - Phone:513-425-7996
Practice Address - Fax:513-425-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTRICARE
087672800OtherDEPT. OF LABOR
=========OtherOH BWC
=========OtherUNITED HEALTHCARE
OH000000021402OtherANTHEM
OHP00149786OtherRAILROAD MEDICARE
OH0523982Medicaid
OH=========OtherMEDICAL MUTUAL
9201072Medicare PIN