Organization
SOUTH LORAIN COUNTY AMBULANCE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAT WILCOXEN (DIRECTOR)
(440) 647-5803
Entity
Organization
Contact information
Practice address
179 E HERRICK AVE, WELLINGTON, OH 44090-1302
(440) 647-5803
(440) 647-4252
Mailing address
179 E HERRICK AVE, WELLINGTON, OH 44090-1302
(440) 647-5803
(440) 647-4252
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
02-0420300
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155432
BCBS
OH
05
—
0453683
—
OH
01
—
792590162
RR MEDICARE
OH
Enumeration date
01/12/2007
Last updated
06/24/2008
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