Organization
JACKSON COUNTY
Active
Parent organization
JACKSON COUNTY
Other names
Jackson County Ambulance Service
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACKSON COUNTY
Authorized official
MR. KENTON SCHAFER (DIRECTOR)
(618) 529-5158
Entity
Organization
Contact information
Practice address
10169 OLD HIGHWAY 13, MURPHYSBORO, IL 62966-5534
(618) 529-5158
(618) 529-4387
Mailing address
10169 OLD HIGHWAY 13, MURPHYSBORO, IL 62966-5534
(618) 529-5158
(618) 529-4387
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
55198
IL
343800000X
Secured Medical Transport (VAN)
55198
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106019
BC & BS OF TN
IL
01
—
039780118
BLUE CROSS BLUE SHIELD
IL
01
—
8862812
BLACK LUNG
IL
01
—
HEALTHLINK
112726
IL
01
—
P00290482
PALMETTO GBA
IL
Enumeration date
08/31/2006
Last updated
06/14/2023
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