Provider Demographics
NPI:1528614161
Name:AMICH, JASON (DHSC, NRP, MBA)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:AMICH
Suffix:
Gender:M
Credentials:DHSC, NRP, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3965 W 106TH ST STE 140
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7781
Mailing Address - Country:US
Mailing Address - Phone:800-538-5513
Mailing Address - Fax:
Practice Address - Street 1:3965 W 106TH ST STE 140
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7781
Practice Address - Country:US
Practice Address - Phone:800-538-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-09
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1171-1970146L00000X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No174H00000XOther Service ProvidersHealth Educator