Provider Demographics
NPI:1821091893
Name:DONALD MARTENS & SONS AMBULANCE SERVICE INC.
Entity Type:Organization
Organization Name:DONALD MARTENS & SONS AMBULANCE SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-234-6000
Mailing Address - Street 1:10830 BROOKPARK RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-1119
Mailing Address - Country:US
Mailing Address - Phone:440-234-6000
Mailing Address - Fax:440-234-8371
Practice Address - Street 1:10830 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-1119
Practice Address - Country:US
Practice Address - Phone:440-234-6000
Practice Address - Fax:440-234-8371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH180022146L00000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000155547OtherANTHEM
OH0175993Medicaid
OH000000155547OtherANTHEM
OH0175993Medicaid