Active NPI
Village of Hicksville
- Ambulance
- Hicksville, OH
National Provider Identifier
1104894013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- VILLAGE OF HICKSVILLE
- Practice address
- 111 S Main St
Hicksville, OH 43526-1398 - Phone
- (419) 542-6138
- Fax
- (419) 542-2018
- NPI assigned
- Mar 8, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cheryl Smith
- Title
- Fiscal Officer
- Phone
- (419) 487-1253
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Primary |
Addresses
Primary practice location
111 S Main St
Hicksville, OH 43526-1398
Mailing address
PO Box 392907
Pittsburgh, PA 15251-9907
Phone (800) 962-1484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0541257 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061220000499 | OH | Part B Supplier - Ambulance Service Supplier | 0648279604 | Practice locations: Hicksville, OH |
National Provider Directory
National Provider DirectoryLocations
111 S Main St
Hicksville, OH 43526
Phone (419) 542-1348
510 W High St
Hicksville, OH 43526
Phone (419) 542-9752
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713225600000",
"number": "1104894013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 392907",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152519907",
"telephone_number": "800-962-1484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S MAIN ST",
"city": "HICKSVILLE",
"state": "OH",
"postal_code": "435261398",
"telephone_number": "419-542-6138",
"fax_number": "419-542-2018"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VILLAGE OF HICKSVILLE",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-08",
"last_updated": "2024-04-16",
"certification_date": "2024-04-16",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "CHERYL",
"authorized_official_title_or_position": "FISCAL OFFICER",
"authorized_official_telephone_number": "419-487-1253"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0541257",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hicksville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.