MEDICARE: JACKSON EDWARDS

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1922795434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKSON EDWARDS

Provider Business Mailing Address
First Line	:	8637 STATE ROUTE 41
Second Line	:
City	:	WEST UNION
State	:	OH
Zip	:	45693-8962
Country	:	US
Telephone Number	:	937-779-7499
Fax Number	:

Provider Business Practice Location Address
First Line	:	8637 STATE ROUTE 41
Second Line	:
City	:	WEST UNION
State	:	OH
Zip	:	45693-8962
Country	:	US
Telephone Number	:	937-779-7499
Fax Number	:

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

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	04/24/2023

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1255092870 — HEBRON AT HOME MINISTRIES
Practice Location Address:

8637 STATE ROUTE 41
WEST UNION, OH
45693-8962

Practice Phone: 937-779-5399
Practice Fax: 888-244-5358

1386330082 — KEITH EDWARDS
Practice Location Address:

8637 STATE ROUTE 41
WEST UNION, OH
45693-8962

Practice Phone: 937-515-8535
Practice Fax:

1245926757 — SUSAN CARLEN
Practice Location Address:

8637 STATE ROUTE 41
WEST UNION, OH
45693-8962

Practice Phone: 727-270-4921
Practice Fax:

1992567150 — AMBER REDMAN
Practice Location Address:

8637 STATE ROUTE 41
WEST UNION, OH
45693-8962

Practice Phone: 937-798-1477
Practice Fax:

1487590089 — MS. TARA CRABTREE ED.S., NCSP
Practice Location Address:

141 LLOYD RD
WEST UNION, OH
45693-8974

Practice Phone: 937-544-5586
Practice Fax:

Directions to “ JACKSON EDWARDS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.