Jackson Township Tustees
Organization Active NPI Ambulance · North Jackson, OH
NPI 1790368595 · NPPES record last updated Aug 26, 2021
Key facts
- NPI
- 1790368595
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- JACKSON TOWNSHIP TUSTEES
- Practice address
- 229 N Salem Warren Rd
North Jackson, OH 44451 - Phone
- (330) 538-2087
- NPI assigned
- Apr 30, 2021
- Organization subpart
- No
Authorized official
- Name
- Mr. Michael C Mortimer, EMT-B
- Title
- EMS Battalion Chief
- Phone
- (330) 240-5458
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210825003635 | OH | Part B Supplier - Ambulance Service Supplier | 2567867708 | Practice locations: North Jackson, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes |
Addresses
Primary practice location
229 N Salem Warren Rd
North Jackson, OH 44451
Mailing address
PO Box 205
North Jackson, OH 44451-0205
Phone (330) 538-3093
Other names
- Jackson Township
- Jackson Township Volunteer Fire Department
Other providers in North Jackson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2021. 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.