Provider Demographics
NPI:1225369069
Name:TRI STATE AMBULANCE INC
Entity Type:Organization
Organization Name:TRI STATE AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-484-8894
Mailing Address - Street 1:2511 WAYNESBURG DR SE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44707-2063
Mailing Address - Country:US
Mailing Address - Phone:330-484-8894
Mailing Address - Fax:330-232-9917
Practice Address - Street 1:7100 WHIPPLE AVE NW STE C
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7167
Practice Address - Country:US
Practice Address - Phone:330-478-4111
Practice Address - Fax:330-232-9917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport