Provider Demographics
NPI:1235351636
Name:COMMUNITY AMBULANCE INC.
Entity Type:Organization
Organization Name:COMMUNITY AMBULANCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:SPONAUGLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:330-527-4100
Mailing Address - Street 1:9330 MARKET SQUARE DRIVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241
Mailing Address - Country:US
Mailing Address - Phone:330-626-5450
Mailing Address - Fax:330-626-5850
Practice Address - Street 1:10804 FOREST STREET
Practice Address - Street 2:
Practice Address - City:GARRETTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44231
Practice Address - Country:US
Practice Address - Phone:330-527-4100
Practice Address - Fax:330-527-2671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0262451Medicaid
OH0262451Medicaid