NPIMap

Organization Active NPI

Advanced Ambulance LLC

  • Ambulance
  • N Royalton, OH
National Provider Identifier
1376509612
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
ADVANCED AMBULANCE LLC
Practice address
8641 W 130TH St
N Royalton, OH 44133
Phone
(440) 230-5339
Fax
(440) 230-5329
NPI assigned
Apr 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Edmund H Gates Jr.
Title
Ceo
Phone
(440) 230-5339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

Addresses

Primary practice location

8641 W 130TH St
N Royalton, OH 44133

Mailing address

1026 Pearl Rd
Ste 5
Brunswick, OH 44212
Phone (440) 230-5339

Other identifiers 1

IdentifierTypeStateIssuer
2097645MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376509612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 PEARL RD",
            "address_2": "STE 5",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "44212",
            "telephone_number": "440-230-5339",
            "fax_number": "440-230-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8641 W 130TH ST",
            "city": "N ROYALTON",
            "state": "OH",
            "postal_code": "44133",
            "telephone_number": "440-230-5339",
            "fax_number": "440-230-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED AMBULANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-230-5339",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2097645",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in N Royalton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.