Provider Demographics
NPI:1174683510
Name:UNITED AMBULANCE SERVICE OF CAMBRIDGE INC
Entity Type:Organization
Organization Name:UNITED AMBULANCE SERVICE OF CAMBRIDGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-439-4880
Mailing Address - Street 1:PO BOX 1118
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-6118
Mailing Address - Country:US
Mailing Address - Phone:740-439-4880
Mailing Address - Fax:740-439-2371
Practice Address - Street 1:1331 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2928
Practice Address - Country:US
Practice Address - Phone:740-439-4880
Practice Address - Fax:740-439-2371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020381650341600000X
OH020381651341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000155067OtherBCBS
OH590002041OtherRR MEDICARE
OH000206374OtherMT STATE
OH0550112Medicaid
OH0550112Medicaid
OH590002041OtherRR MEDICARE
OH=========0006OtherMEDMUTUAL
OH9205751Medicare PIN