Jeromesville Fire District
Organization Active NPI Ambulance · Jeromesville, OH
NPI 1467423236 · NPPES record last updated Feb 17, 2009
Key facts
- NPI
- 1467423236
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 020736400 (OH)
- Legal business name
- JEROMESVILLE FIRE DISTRICT
- Practice address
- North Huron Street
Jeromesville, OH 44840-0414 - Phone
- (419) 368-6811
- Fax
- (419) 368-4147
- NPI assigned
- Jan 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Mary T Gentile
- Title
- Authorized Agent
- Phone
- (860) 257-7080
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050328000282 | OH | Part B Supplier - Ambulance Service Supplier | 1951357565 | Practice locations: Jeromesville, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 020736400 | OH | Yes |
Addresses
Primary practice location
North Huron Street
Jeromesville, OH 44840-0414
Mailing address
PO Box 290184
Wethersfield, CT 06129-0184
Phone (800) 336-6402
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2553811 | Medicaid | OH | |
| P00641859 | Other | OH | RAILROAD MEDICARE |
Other providers in Jeromesville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2009. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.