Provider Demographics
NPI:1578982286
Name:AMERICAN EMS, LLC
Entity Type:Organization
Organization Name:AMERICAN EMS, LLC
Other - Org Name:STARK SUMMIT AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRICKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-837-9806
Mailing Address - Street 1:1310 ERIE ST S
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-7906
Mailing Address - Country:US
Mailing Address - Phone:330-937-9806
Mailing Address - Fax:
Practice Address - Street 1:1310 ERIE ST S
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-7906
Practice Address - Country:US
Practice Address - Phone:330-937-9806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance