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JACKSON FOREST AMBULANCE DISTRICT
NPI 1467516948
Ambulance in Forest, OH

Active since December 20, 2006CLIA 36D0862504 · Waiver
211 W LIMA ST, FOREST, OH 45843(419) 273-2713(419) 273-7108 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 12, 2024, Jul 11, 2016 (2 updates tracked since 2016).

About Jackson Forest Ambulance District NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON FOREST AMBULANCE DISTRICT (NPI 1467516948) is a healthcare organization registered as an ambulance in Forest, Ohio and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Charity Anne Holland, Fiscal Officer, as its authorized official.

NPPES Registry Identity

NPI1467516948
Entity TypeOrganization
Primary Taxonomy341600000X
Legal Business NameJACKSON FOREST EMERGENCY AMBULANCE SERVICE
Location Address211 W LIMA STForest, OH 45843-1129
Mailing AddressPo Box 21727Cleveland, OH 44121-0727 · (440) 605-9117 · Fax (440) 442-4443
Phone(419) 273-2713
Fax(419) 273-7108
Organization SubpartNo
Authorized OfficialCharity Anne HollandFiscal Officer · (419) 957-2781
Enumeration DateDecember 20, 2006
Last NPPES UpdateJune 12, 20242 updates tracked since enumeration
NPPES CertifiedJune 12, 2024
✔ NPI 1467516948 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAmbulanceTransportation Services
Taxonomy Code341600000X
Definition
An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane).
Also ListedAmbulance · Land TransportTaxonomy 3416L0300X
211 W LIMA ST, Forest, OH 45843
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Other Names 1

Doing Business AsJackson Forest Ambulance District

Other Identifiers 2

Medicaid0310569OH
Other590006210OH · Railroad Medicare

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D0862504

Jackson-Forest Ambulance District · Forest, OH
Active · expires Aug 31, 2026
CLIA Number36D0862504
Laboratory TypeOther
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMichael R. Humphrey MD
Laboratory Phone(419) 273-2520
Laboratory LocationJackson-Forest Ambulance District211 West Lima Street, Forest, OH 45843
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ground mileage, per statute mile A0425
Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.
314 services16 patients
Ambulance service, basic life support, emergency transport (bls-emergency) A0429
Ambulance service with basic life support (BLS-Emergency) provides immediate transport for patients in critical situations. Medical professionals on board deliver essential care like CPR, wound dressing, and oxygen therapy to stabilize patients during the journey.
12 services12 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Forest Emergency Ambulance Service's NPI number?

The NPI number for Jackson Forest Emergency Ambulance Service is 1467516948. It was assigned to this organization in the NPPES registry on December 20, 2006. The provider is doing business as Jackson Forest Ambulance District.

Where is Jackson Forest Emergency Ambulance Service located?

Jackson Forest Emergency Ambulance Service is located at 211 W Lima St, Forest, OH 45843. The listed phone number is (419) 273-2713.

What is Jackson Forest Emergency Ambulance Service's specialty?

The primary specialty registered for this NPI is Ambulance with taxonomy code 341600000X.

Does Jackson Forest Emergency Ambulance Service hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0862504) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jackson Forest Emergency Ambulance Service was last updated on June 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.