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General NPI Number Information
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NPI Number | 1790368595
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Entity Type | Organization
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Legal Business Name | JACKSON TOWNSHIP TUSTEES
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 229 N SALEM WARREN RD
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City | NORTH JACKSON
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State | OH
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Zip | 44451
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Country | US
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Telephone | 330-538-2087
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 205
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City | NORTH JACKSON
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State | OH
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Zip | 44451-0205
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Country | US
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Telephone | 330-538-3093
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Fax |
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Authorized Official
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Title or Position | EMS BATTALION CHIEF
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Name | MR. MICHAEL C MORTIMER
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Credential | EMT-B
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Telephone | 330-240-5458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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