Provider Demographics
NPI:1760448641
Name:CC&S AMBULANCE INC
Entity Type:Organization
Organization Name:CC&S AMBULANCE INC
Other - Org Name:BARTLEY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-868-4114
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:
Mailing Address - City:MINERVA
Mailing Address - State:OH
Mailing Address - Zip Code:44657-0374
Mailing Address - Country:US
Mailing Address - Phone:330-868-4114
Mailing Address - Fax:330-868-5007
Practice Address - Street 1:208 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-1647
Practice Address - Country:US
Practice Address - Phone:330-868-4114
Practice Address - Fax:330-868-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3416L0300X341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000227102OtherHIGHMARK
OH000000155809OtherANTHEM
OH800350OtherBLACK LUNG
OH0004468230OtherAETNA
OH0959208Medicaid
OH800350OtherBLACK LUNG
OH0959208Medicaid
OH000000227102OtherHIGHMARK