Provider Demographics
NPI:1700819695
Name:PHYSICIANS & SURGEONS AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:PHYSICIANS & SURGEONS AMBULANCE SERVICE INC
Other - Org Name:AMERICAN MEDICAL RESPONSE OF OHIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF REVENUE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-703-2294
Mailing Address - Street 1:PO BOX 100217
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0217
Mailing Address - Country:US
Mailing Address - Phone:833-703-2294
Mailing Address - Fax:
Practice Address - Street 1:8261 STATE ROUTE 235
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-6383
Practice Address - Country:US
Practice Address - Phone:937-543-6881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6922209Medicaid
OHOH0000D100109OtherSECTION 1011
OH9013931Medicare PIN
OH6922209Medicaid
OHOH0000D100109OtherSECTION 1011