1144225772 NPI number — MID-OHIO AMBULANCE SERVICE INC

Table of content: (NPI 1144225772)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144225772 NPI number — MID-OHIO AMBULANCE SERVICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MID-OHIO AMBULANCE SERVICE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144225772
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 985
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-654-6100
Provider Business Mailing Address Fax Number:
740-654-6679

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
655 S COLUMBUS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-654-6100
Provider Business Practice Location Address Fax Number:
740-654-6679
Provider Enumeration Date:
06/20/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
MELODY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
740-654-6100

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  230042 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000155019 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0325080 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: AN93225250001 . This is a "CIGNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 9727 . This is a "CHCS NATIONWIDE INS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: AN9322525001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 81-80114 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 8187024 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0004450573 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0004450573 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 81-87024 . This is a "MAIL HANDLERS INSUR" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 863028 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 863028 . This is a "FED BLK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9727 . This is a "NATIONWIDE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 071701000008 . This is a "CENTRAL BENEFITS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 8180114 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: G217 . This is a "MEDIGOLD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".