Organization
VILLAGE OF SOUTH JACKSONVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A HICKOX (FIRE CHIEF)
(217) 245-4803
Entity
Organization
Contact information
Practice address
301 DEWEY DR, JACKSONVILLE, IL 62650-3206
(217) 245-4803
Mailing address
PO BOX 42, MANCHESTER, IL 62663-0042
(217) 587-4761
(217) 587-2101
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
341600000X
IL
Other
Enumeration date
09/08/2008
Last updated
12/30/2008
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