Provider Demographics
NPI:1497756043
Name:JAY COUNTY GOVERNMENT
Entity Type:Organization
Organization Name:JAY COUNTY GOVERNMENT
Other - Org Name:JAY COUNTY EMERGENCY MEDICAL SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-775-6753
Mailing Address - Street 1:PO BOX 502250
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-7250
Mailing Address - Country:US
Mailing Address - Phone:317-775-6751
Mailing Address - Fax:317-849-6632
Practice Address - Street 1:902 N CREAGOR AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371
Practice Address - Country:US
Practice Address - Phone:260-726-2311
Practice Address - Fax:260-726-2371
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAY COUNTY GOVERNMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-04
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0021341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN107298OtherCHILDRENS SPECIAL HEALTH
OH0506938Medicaid
IN100281680AMedicaid
881803OtherFEDERAL BLACK LUNG
000000201427OtherBLUE CROSS
590008516OtherRR RETIREMENT/UHC
590008516OtherRR RETIREMENT/UHC