Provider Demographics
NPI:1700854171
Name:RURAL/METRO AMBULANCE OF CENTRAL OHIO, INC
Entity Type:Organization
Organization Name:RURAL/METRO AMBULANCE OF CENTRAL OHIO, INC
Other - Org Name:RURAL/METRO AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:STREETY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-882-8400
Mailing Address - Street 1:481 WILLIAM GAITER PKWY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2731
Mailing Address - Country:US
Mailing Address - Phone:716-882-8400
Mailing Address - Fax:716-887-8379
Practice Address - Street 1:202 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-3908
Practice Address - Country:US
Practice Address - Phone:614-732-5601
Practice Address - Fax:614-358-0982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2503623416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2177228Medicaid
OH9282631Medicare ID - Type UnspecifiedMARION MEDICARE #