Provider Demographics
NPI:1386770592
Name:HAMM AMBULANCE SERVICE, INC.
Entity type:Organization
Organization Name:HAMM AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-398-1984
Mailing Address - Street 1:4380 SKY LANE DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-3746
Mailing Address - Country:US
Mailing Address - Phone:216-398-1984
Mailing Address - Fax:440-238-3058
Practice Address - Street 1:4380 SKY LANE DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-3746
Practice Address - Country:US
Practice Address - Phone:216-398-1984
Practice Address - Fax:440-238-3058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1800423416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2011103Medicaid
OHHA9247281Medicare ID - Type UnspecifiedLAND AMBULANCE 41