# JACKSON COUNTY B O C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jackson County Emergency Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982755138
- **Authorized official:** JASON BAKER (EMS DIRECTOR)
- **Authorized official phone:** (706) 367-6356

## Contact information

- **Practice address:** 86 GORDON ST, JEFFERSON, GA 30549-1528
- **Practice address phone:** (833) 810-5005
- **Practice address fax:** (888) 965-4620
- **Mailing address:** PO BOX 936418, ATLANTA, GA 31193-6418
- **Mailing address phone:** (833) 810-5005
- **Mailing address fax:** (888) 965-4620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 078-02 | GA | Yes |

## Other

- **Enumeration date:** 01/15/2007
- **Last updated:** 12/26/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000055976A | — | GA |
| 01 | — | 191662 | BCBS | GA |
| 01 | — | 590603182 | RAILROAD MEDICARE | GA |
| 01 | — | NH540 | WELLCARE | GA |