Provider Demographics
NPI:1609428499
Name:JCTH HOLDINGS INC.
Entity Type:Organization
Organization Name:JCTH HOLDINGS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:J GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:ROOF
Authorized Official - Suffix:
Authorized Official - Credentials:NHA, HSE
Authorized Official - Phone:330-385-7100
Mailing Address - Street 1:48444 BELL SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:CALCUTTA
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9646
Mailing Address - Country:US
Mailing Address - Phone:330-385-7100
Mailing Address - Fax:
Practice Address - Street 1:48444 BELL SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CALCUTTA
Practice Address - State:OH
Practice Address - Zip Code:43920-9646
Practice Address - Country:US
Practice Address - Phone:330-385-7100
Practice Address - Fax:330-385-8434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0286214Medicaid