Organization
COMMUNITY CARE AMBULANCE NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM EGELAND (CFO)
(440) 992-1401
Entity
Organization
Contact information
Practice address
115 E 24TH STREET, ASHTABULA, OH 44004
(440) 992-1401
(440) 992-1315
Mailing address
115 E 24TH STREET, ASHTABULA, OH 44004
(440) 992-1401
(440) 992-6331
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155830
BLUE CROSS BLUE SHIELD
OH
05
—
0972783
—
OH
01
—
590008084
RAILROAD MEDICARE
OH
Enumeration date
03/04/2007
Last updated
04/19/2023
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