# CITIZENS AMBULANCE SERVICE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023174851
- **Authorized official:** MR. LUCAS PALM PARAMEDIC (EMS COORDINATOR)
- **Authorized official phone:** (440) 839-2144

## Contact information

- **Practice address:** 19 RAILROAD ST, WAKEMAN, OH 44889
- **Practice address phone:** (440) 839-2144
- **Practice address fax:** (440) 839-1481
- **Mailing address:** PO BOX 224, 19 RAILROAD ST, WAKEMAN, OH 44889
- **Mailing address phone:** (440) 839-2144
- **Mailing address fax:** (440) 839-1481

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | OH | Yes |

## Other

- **Enumeration date:** 12/28/2006
- **Last updated:** 05/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000155451 | ANTHEM BCBS | KY |
| 05 | — | 0384445 | — | OH |
| 01 | — | 590000907 | RAILROAD MEDICARE | — |
| 01 | — | 9163191 | MEDICARE | OH |
| 01 | — | ========= | MEDICAL MUT | OH |