Provider Demographics
NPI:1790368595
Name:JACKSON TOWNSHIP TUSTEES
Entity Type:Organization
Organization Name:JACKSON TOWNSHIP TUSTEES
Other - Org Name:JACKSON TOWNSHIP VOLUNTEER FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS BATTALION CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORTIMER
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-B
Authorized Official - Phone:330-240-5458
Mailing Address - Street 1:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:NORTH JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:44451-0205
Mailing Address - Country:US
Mailing Address - Phone:330-538-3093
Mailing Address - Fax:
Practice Address - Street 1:229 N SALEM WARREN RD
Practice Address - Street 2:
Practice Address - City:NORTH JACKSON
Practice Address - State:OH
Practice Address - Zip Code:44451
Practice Address - Country:US
Practice Address - Phone:330-538-2087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance