1316945124 NPI number — NORTH CENTRAL AMBULANCE DISTRICT

Table of content: (NPI 1316945124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316945124 NPI number — NORTH CENTRAL AMBULANCE DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH CENTRAL AMBULANCE DISTRICT
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:
6
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:
1316945124
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
836 4TH AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701-1407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-521-1576
Provider Business Mailing Address Fax Number:
304-521-1576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
131 EAST MAIN CROSS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELDORADO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45321-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-533-5639
Provider Business Practice Location Address Fax Number:
304-521-1576
Provider Enumeration Date:
07/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HART
Authorized Official First Name:
TABETHA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
737-533-5639

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  020991450 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000008067 . This is a "BCBS OF OH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 590000069 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000008067 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0145838000 . This is a "WV MEDICAID" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0357975 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0410433 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200361400A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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