Healthcare Provider Details

I. General information

NPI: 1396702627
Provider Name (Legal Business Name): JACKSON TOWNSHIP FRANKLIN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 HOOVER RD
GROVE CITY OH
43123-2452
US

IV. Provider business mailing address

PO BOX 639661
CINCINNATI OH
45263-9661
US

V. Phone/Fax

Practice location:
  • Phone: 614-875-5588
  • Fax: 614-875-2691
Mailing address:
  • Phone: 614-875-5588
  • Fax: 614-875-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number02030005013
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: RANDY LITTLE JR.
Title or Position: FIRE CHIEF
Credential:
Phone: 614-875-5588