Healthcare Provider Details

I. General information

NPI: 1720009921
Provider Name (Legal Business Name): SMITH AMBULANCE OF NORTH EAST OH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1344 WEST OLD LINCOLN WAY
WOOSTER OH
44691
US

IV. Provider business mailing address

214 WEST THIRD ST
DOVER OH
44622-2965
US

V. Phone/Fax

Practice location:
  • Phone: 330-262-5517
  • Fax: 330-602-5471
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROBERT L SMITH
Title or Position: PRESIDENT
Credential:
Phone: 300-602-5180