Henry County South Joint Ambulance
Organization Active NPI Land Ambulance · Hamler, OH
NPI 1265624431 · NPPES record last updated Mar 9, 2015
Key facts
- NPI
- 1265624431
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- HENRY COUNTY SOUTH JOINT AMBULANCE
- Practice address
- 625 Edgerton Street
Hamler, OH 43524 - Phone
- (419) 274-2055
- Fax
- (419) 274-3755
- NPI assigned
- Aug 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Pam Austermiller
- Title
- Asst. Director
- Phone
- (419) 274-2055
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2123659 | Henry County South Joint Ambulance | Certificate of waiver | Dec 27, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080123000703 | OH | Part B Supplier - Ambulance Service Supplier | 8921180480 | Practice locations: Hamler, OH |
National Provider Directory
Locations
625 E Edgerton St
Hamler, OH 43524
Phone (419) 274-2055
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
625 Edgerton Street
Hamler, OH 43524
Mailing address
625 Edgerton Street
Hamler, OH 43524
Phone (419) 274-2055
Other providers in Hamler, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.