MEDICARE: MR. EDWARD JASON CRUM HEALTH SERVICE TECH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146N00000X	Basic Emergency Medical Technician	B1757148	CA
2	247200000X	Other Technician		CA

General Provider Information

NPI Number	:	1376683243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD JASON CRUM HEALTH SERVICE TECH.

Provider Business Mailing Address
First Line	:	4200 OCEAN ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32233-2416
Country	:	US
Telephone Number	:	904-564-7581
Fax Number	:	904-564-7583

Provider Business Practice Location Address
First Line	:	4200 OCEAN ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32233-2416
Country	:	US
Telephone Number	:	904-564-7581
Fax Number	:	904-564-7583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	09/11/2025

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