Healthcare Provider Details

I. General information

NPI: 1265624431
Provider Name (Legal Business Name): HENRY COUNTY SOUTH JOINT AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 EDGERTON STREET
HAMLER OH
43524
US

IV. Provider business mailing address

625 EDGERTON STREET
HAMLER OH
43524
US

V. Phone/Fax

Practice location:
  • Phone: 419-274-2055
  • Fax: 419-274-3755
Mailing address:
  • Phone: 419-274-2055
  • Fax: 419-274-3755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAM AUSTERMILLER
Title or Position: ASST. DIRECTOR
Credential:
Phone: 419-274-2055