# CITY OF JACKSONVILLE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730188673
- **Authorized official:** MR. JOHNNY L SMITH (MAYOR)
- **Authorized official phone:** (256) 435-7611

## Contact information

- **Practice address:** 506 CHINABEE AVE SE, JACKSONVILLE, AL 36265-2881
- **Practice address phone:** (256) 435-7611
- **Practice address fax:** (256) 435-4103
- **Mailing address:** 320 CHURCH AVE SE, JACKSONVILLE, AL 36265-2651
- **Mailing address phone:** (256) 435-7611
- **Mailing address fax:** (256) 435-4103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 040281 | AL | Yes |

## Other

- **Enumeration date:** 07/20/2005
- **Last updated:** 02/09/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200008103 | — | AL |