Organization
JACKSON FOREST EMERGENCY AMBULANCE SERVICE
Active
Other names
Jackson Forest Ambulance District
Organization subpart
No
Provider details
NPI number
Authorized official
CHARITY ANNE HOLLAND (FISCAL OFFICER)
(419) 957-2781
Entity
Organization
Contact information
Practice address
211 W LIMA ST, FOREST, OH 45843-1129
(419) 273-2713
(419) 273-7108
Mailing address
PO BOX 21727, CLEVELAND, OH 44121-0727
(440) 605-9117
(440) 442-4443
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0310569
—
OH
01
—
590006210
RAILROAD MEDICARE
OH
Enumeration date
12/20/2006
Last updated
06/12/2024
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