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Organization
JACKSON EMERGENCY TRANSPORT SERVICE, LLC
Active
Organization
JACKSON EMERGENCY TRANSPORT SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN SMITH EMT-P (MANAGER)
(614) 422-7281
Entity
Organization
Contact information
Practice address
133 COURT ST, GROVE HILL, AL 36451-3228
(601) 422-7281
Mailing address
PO BOX 2037, LAUREL, MS 39442-2037
(601) 422-7281
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
552
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200013112
—
AL
01
—
51050479
BCBS
AL
Enumeration date
08/24/2006
Last updated
07/09/2021
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