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General NPI Number Information
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NPI Number | 1194715797
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Entity Type | Organization
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Legal Business Name | CRITICAL CARE AMBULANCE SERVICE, LLC
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 775 W SMITH RD STE 2
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City | MEDINA
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State | OH
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Zip | 44256-3556
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Country | US
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Telephone | 330-725-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 1181 RIVER WOODS DR
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City | HINCKLEY
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State | OH
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Zip | 44233-9750
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Country | US
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Telephone | 330-278-2027
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SANDRA KAY QUINN
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Credential | OWNER
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Telephone | 330-242-3092
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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 |
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License Number State |
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