Provider Demographics
NPI:1588796940
Name:B & C AMBULANCE
Entity Type:Organization
Organization Name:B & C AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-921-3020
Mailing Address - Street 1:3645 WARRENSVILLE CENTER RD STE 302
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5276
Mailing Address - Country:US
Mailing Address - Phone:216-921-3020
Mailing Address - Fax:
Practice Address - Street 1:3645 WARRENSVILLE CENTER RD STE 302
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5276
Practice Address - Country:US
Practice Address - Phone:216-921-3020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0341035Medicaid