Organization
JACKSON COUNTY EMERGENCY SERVICES DISTRICT #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTY VACLAVICK (DISTRICT SECRETARY)
(361) 284-3222
Entity
Organization
Contact information
Practice address
5955 FM 616, VANDERBILT, TX 77991
(361) 284-3222
(361) 284-3572
Mailing address
PO BOX 455, VANDERBILT, TX 77991-0455
(361) 284-3222
(361) 284-3572
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
514825
USED WITH INS. CLAIMS
TX
Enumeration date
07/03/2006
Last updated
08/22/2020
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