Provider Demographics
NPI:1972618403
Name:AMERICAN AMBULANCE
Entity type:Organization
Organization Name:AMERICAN AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHTERS
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:740-355-1000
Mailing Address - Street 1:5870 CLEVELAND AVE
Mailing Address - Street 2:STE D
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2806
Mailing Address - Country:US
Mailing Address - Phone:614-890-8653
Mailing Address - Fax:614-890-2947
Practice Address - Street 1:1032 KINNEYS LN
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2805
Practice Address - Country:US
Practice Address - Phone:740-355-1000
Practice Address - Fax:740-355-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7302823416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK000000391926OtherANTHEM BLUE CROSS
OH2651161Medicaid
OH311387681001OtherMEDICAL MUTUAL
OHP00294212OtherRAILROAD MEDICARE
OH2651161Medicaid
OHP00294212OtherRAILROAD MEDICARE