Provider Demographics
NPI:1528191814
Name:HENRY COUNTY EMERGENCY MEDICAL SERVICE
Entity Type:Organization
Organization Name:HENRY COUNTY EMERGENCY MEDICAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASS'T COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-592-1988
Mailing Address - Street 1:104 E WASHINGTON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-1600
Mailing Address - Country:US
Mailing Address - Phone:419-592-1988
Mailing Address - Fax:419-592-1808
Practice Address - Street 1:104 E WASHINGTON ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-1600
Practice Address - Country:US
Practice Address - Phone:419-592-1988
Practice Address - Fax:419-592-1808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0250599Medicaid
OH0250599Medicaid