Healthcare Provider Details

I. General information

NPI: 1174544373
Provider Name (Legal Business Name): SMITH AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 10/22/2021
Certification Date: 10/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 WEST 11TH ST
DOVER OH
44622
US

IV. Provider business mailing address

7100 WHIPPLE AVE NW STE K
NORTH CANTON OH
44720-7167
US

V. Phone/Fax

Practice location:
  • Phone: 330-602-5180
  • Fax: 330-602-5471
Mailing address:
  • Phone: 330-602-5180
  • Fax: 330-484-2932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: AMY HOCKENBERRY
Title or Position: BILLING MANAGER
Credential:
Phone: 330-602-5180