# JACKSON VOLUNTEER AMBULANCE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jackson Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811915648
- **Authorized official:** MATT SKARET (CITY ADMINISTRATOR)
- **Authorized official phone:** (507) 847-4410

## Contact information

- **Practice address:** 305 SHERIDAN STR, JACKSON, MN 56143-0242
- **Practice address phone:** (507) 847-5306
- **Mailing address:** 80 W ASHLEY ST, JACKSON, MN 56143-1669
- **Mailing address phone:** (507) 847-5306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 0117 | MN | — |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 10/31/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 48400JA | BLUE CROSS BLUE SHIELD | MN |