Provider Demographics
NPI:1366532004
Name:TRI-COUNTY JOINT AMBULANCE SERVICE
Entity type:Organization
Organization Name:TRI-COUNTY JOINT AMBULANCE SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-498-6598
Mailing Address - Street 1:530 S COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:NEWCOMERSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43832-1420
Mailing Address - Country:US
Mailing Address - Phone:740-498-6598
Mailing Address - Fax:
Practice Address - Street 1:530 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:NEWCOMERSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43832-1420
Practice Address - Country:US
Practice Address - Phone:740-498-6598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI-COUNTY JOINT AMBULANCE SERVICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-13
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0426150341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH020426150OtherBOARD OF PHARMACY
OH0177473Medicaid
OH590003618OtherRRMEDICARE
OH590003618OtherRRMEDICARE
OH001705102OtherMT.STATE
OH590003618OtherRRMEDICARE
OH=========OtherUMWA
OH=========-001OtherMEDMUTUAL
OH343662126200OtherBCBS