Healthcare Provider Details

I. General information

NPI: 1588669592
Provider Name (Legal Business Name): AMBULANCE ASSOCIATES OF CANTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 12/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 CLARENDON AVE NW
CANTON OH
44708-4623
US

IV. Provider business mailing address

114 CLARENDON AVE NW
CANTON OH
44708-4623
US

V. Phone/Fax

Practice location:
  • Phone: 330-452-1113
  • Fax: 330-452-5344
Mailing address:
  • Phone: 330-452-1113
  • Fax: 330-452-5344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number760052
License Number StateOH

VIII. Authorized Official

Name: MR. RICHARD BABB
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 330-452-1113