1104872142 NPI number — EMERGENCY MEDICAL TRANSPORT INC

Table of content: (NPI 1104872142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104872142 NPI number — EMERGENCY MEDICAL TRANSPORT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMERGENCY MEDICAL TRANSPORT 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:
1104872142
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7100 WHIPPLE AVE NW STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH CANTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44720-7167
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-484-8894
Provider Business Mailing Address Fax Number:
330-484-2932

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7100 WHIPPLE AVE NW STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CANTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44720-7167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-478-4111
Provider Business Practice Location Address Fax Number:
330-232-9917
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JOSEPH
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CHIEF PARAMEDIC
Authorized Official Telephone Number:
330-484-8894

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X , with the licence number:  021103550 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8001026000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2000051 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000155881 . This is a "BCBS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 00023436 . This is a "MT.STATE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 3481838901 . This is a "BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 590010656 . This is a "RR MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 800024 . This is a "BLACKLUNG" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com