Provider Demographics
NPI:1023397676
Name:MID COUNTY JOINT AMBULANCE DISTRICT
Entity Type:Organization
Organization Name:MID COUNTY JOINT AMBULANCE DISTRICT
Other - Org Name:MID CO JOINT AMBULANCE DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KENAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MYLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-898-9366
Mailing Address - Street 1:PO BOX 637483
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7483
Mailing Address - Country:US
Mailing Address - Phone:855-626-9660
Mailing Address - Fax:833-953-0588
Practice Address - Street 1:222 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-1148
Practice Address - Country:US
Practice Address - Phone:419-898-9366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0319750341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0057071Medicaid
OHP00997287OtherRAILROAD MEDICARE
OH000000745446OtherANTHEM
OHP00997287OtherRAILROAD MEDICARE