Provider Demographics
NPI:1174544373
Name:SMITH AMBULANCE SERVICE INC
Entity type:Organization
Organization Name:SMITH AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCKENBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-602-5180
Mailing Address - Street 1:7100 WHIPPLE AVE NW
Mailing Address - Street 2:STE K
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7167
Mailing Address - Country:US
Mailing Address - Phone:330-602-5180
Mailing Address - Fax:330-484-2932
Practice Address - Street 1:508 WEST 11TH ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622
Practice Address - Country:US
Practice Address - Phone:330-602-5180
Practice Address - Fax:330-602-5471
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMITH MEDICAL TRANSPORTATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0519808Medicaid
OH590011205OtherRAILROAD MEDICARE
OH000000155802OtherANTHEM
OH=========008OtherMEDICAL MUTUAL
OH=========00OtherWORKERS COMPENSATION
OH0519808Medicaid