Provider Demographics
NPI:1659322097
Name:HILLCREST AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:HILLCREST AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-797-4009
Mailing Address - Street 1:26420 LAKELAND BLVD
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2642
Mailing Address - Country:US
Mailing Address - Phone:216-797-4000
Mailing Address - Fax:216-797-4016
Practice Address - Street 1:26420 LAKELAND BLVD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-2642
Practice Address - Country:US
Practice Address - Phone:216-797-4000
Practice Address - Fax:216-797-4016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1800523416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000155431OtherOHIO ANTHEM
OH0139442Medicaid
OH58690OtherQUALCHOICE
OH000000155431OtherOHIO ANTHEM