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General NPI Number Information
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NPI Number | 1063600799
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Entity Type | Organization
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Legal Business Name | SMITH AMBULANCE OF STARK-SUMMIT INC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 214 W 3RD ST
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City | DOVER
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State | OH
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Zip | 44622-2965
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Country | US
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Telephone | 330-602-5180
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Fax | 330-602-5471
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Provider Business Mailing Address
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Address Line | 1310 ERIE STREET SOUTH
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City | MASSILLON
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State | OH
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Zip | 44646-5545
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Country | US
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Telephone | 330-837-5748
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT L SMITH
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Credential |
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Telephone | 330-602-4718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 021762803
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 021762802
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 021762801
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 021762806
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 021762800
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License Number State | OH
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