Provider Demographics
NPI:1336251933
Name:MINERAL-SANDY AMBULANCE DISTRICT
Entity type:Organization
Organization Name:MINERAL-SANDY AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-859-2195
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:MINERAL CITY
Mailing Address - State:OH
Mailing Address - Zip Code:44656-0454
Mailing Address - Country:US
Mailing Address - Phone:330-859-2195
Mailing Address - Fax:330-874-4302
Practice Address - Street 1:8495 S HIGH STREET
Practice Address - Street 2:
Practice Address - City:MINERAL CITY
Practice Address - State:OH
Practice Address - Zip Code:44656
Practice Address - Country:US
Practice Address - Phone:330-859-2195
Practice Address - Fax:330-874-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH021010850OtherBOARD OF PHARMACY
OH2346992Medicaid
OH=========0-00OtherOH WORKERS COMPANSATION