# JACKSON EMERGENCY TRANSPORT SERVICE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1831206713
- **Authorized official:** MR. KEVIN SMITH EMT-P (MANAGER)
- **Authorized official phone:** (614) 422-7281

## Contact information

- **Practice address:** 133 COURT ST, GROVE HILL, AL 36451-3228
- **Practice address phone:** (601) 422-7281
- **Mailing address:** PO BOX 2037, LAUREL, MS 39442-2037
- **Mailing address phone:** (601) 422-7281

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 552 | AL | Yes |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 07/09/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200013112 | — | AL |
| 01 | — | 51050479 | BCBS | AL |