Healthcare Provider Details

I. General information

NPI: 1528614161
Provider Name (Legal Business Name): JASON AMICH DHSC, NRP, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2019
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3965 W 106TH ST STE 140
CARMEL IN
46032-7781
US

IV. Provider business mailing address

3965 W 106TH ST STE 140
CARMEL IN
46032-7781
US

V. Phone/Fax

Practice location:
  • Phone: 800-538-5513
  • Fax:
Mailing address:
  • Phone: 800-538-5513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number1171-1970
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: