1356346647 NPI number — NORTH EAST AMBULANCE SERVICE, INC.

Table of content: LINDSAY RENEE HARNESS NP (NPI 1982359881)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356346647 NPI number — NORTH EAST AMBULANCE SERVICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH EAST 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:
1356346647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4830 HARDING AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAVENNA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44266-8813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-296-4541
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4830 HARDING AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAVENNA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44266-8813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-296-4541
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
TURLEY
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
330-296-4541

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  670022 , 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: 0967851 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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