Healthcare Provider Details

I. General information

NPI: 1356346647
Provider Name (Legal Business Name): NORTH EAST AMBULANCE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 12/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4830 HARDING AVE
RAVENNA OH
44266-8813
US

IV. Provider business mailing address

4830 HARDING AVE
RAVENNA OH
44266-8813
US

V. Phone/Fax

Practice location:
  • Phone: 330-296-4541
  • Fax:
Mailing address:
  • Phone: 330-296-4541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number670022
License Number StateOH

VIII. Authorized Official

Name: ROBERT E TURLEY
Title or Position: PRESIDENT
Credential:
Phone: 330-296-4541