Provider Demographics
NPI:1851302822
Name:HOCKING VALLEY HEALTH PROFESSIONALS, INC
Entity Type:Organization
Organization Name:HOCKING VALLEY HEALTH PROFESSIONALS, INC
Other - Org Name:HEALTH PRO AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-753-9357
Mailing Address - Street 1:PO BOX 91
Mailing Address - Street 2:
Mailing Address - City:CARBON HILL
Mailing Address - State:OH
Mailing Address - Zip Code:43111-0091
Mailing Address - Country:US
Mailing Address - Phone:740-753-9357
Mailing Address - Fax:740-753-9571
Practice Address - Street 1:15047 FIRST ST.
Practice Address - Street 2:
Practice Address - City:CARBON HILL
Practice Address - State:OH
Practice Address - Zip Code:43111-0091
Practice Address - Country:US
Practice Address - Phone:740-753-9357
Practice Address - Fax:740-753-9571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0500123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0686548Medicaid
OH9225131Medicare ID - Type UnspecifiedAMUBULANCE PROVIDER