Organization
MARIETTA AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER DALE ANDERSON M.D. (PRESIDENT)
(740) 516-4404
Entity
Organization
Contact information
Practice address
101 PUTNAM ST, MARIETTA, OH 45750-2924
(740) 516-4404
(304) 424-4858
Mailing address
101 PUTNAM ST, MARIETTA, OH 45750-2924
(740) 516-4404
(304) 424-4858
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
920507
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0224788
—
OH
Enumeration date
04/03/2009
Last updated
04/03/2009
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