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Organization

JACKSON PARISH AMBULANCE SERVICE DISTRICT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TRACY BRANDON WOLD BS EMT-P (EMS DIRECTOR)
(318) 259-2877
Entity
Organization

Contact information

Practice address
115 WATTS ST, JONESBORO, LA 71251-2053
(318) 259-2891
(318) 259-2099
Mailing address
115 WATTS ST, JONESBORO, LA 71251-2053
(318) 259-2891
(318) 259-2099

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
9110021
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1550426
LA
01
F4632
BLUE CROSS BLUE SHIELD
LA
01
P00634556
RAILROAD MEDICARE (PALMETTO GBA)
LA
Enumeration date
05/24/2005
Last updated
08/30/2010
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