Healthcare Provider Details

I. General information

NPI: 1225369069
Provider Name (Legal Business Name): TRI STATE AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

2511 WAYNESBURG DR SE
CANTON OH
44707-2063
US

V. Phone/Fax

Practice location:
  • Phone: 330-478-4111
  • Fax: 330-232-9917
Mailing address:
  • Phone: 330-484-8894
  • Fax: 330-232-9917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH J JOSEPH
Title or Position: OWNER
Credential:
Phone: 330-484-8894