Provider Demographics
NPI:1023170867
Name:AKRON CITY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:AKRON CITY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMYLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-375-2960
Mailing Address - Street 1:177 S BROADWAY ST RM 215
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1738
Mailing Address - Country:US
Mailing Address - Phone:330-375-2960
Mailing Address - Fax:330-375-2154
Practice Address - Street 1:177 S BROADWAY ST RM 215
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1738
Practice Address - Country:US
Practice Address - Phone:330-375-2960
Practice Address - Fax:330-375-2154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0980005Medicaid
OH0980005Medicaid