Provider Demographics
NPI:1144302084
Name:SCIOTO AMBULANCE DISTRICT
Entity type:Organization
Organization Name:SCIOTO AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:W
Authorized Official - Last Name:EICHENLAUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-259-0755
Mailing Address - Street 1:PO BOX 392907
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9907
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:57 BARKER STREET
Practice Address - Street 2:
Practice Address - City:MCDERMOTT
Practice Address - State:OH
Practice Address - Zip Code:45652
Practice Address - Country:US
Practice Address - Phone:740-259-4767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000380084OtherANTHEM
OH2576270Medicaid
P00249560OtherRAILROAD MEDICARE
OH2576270Medicaid