Organization
JACKSON COUNTY COURT HOUSE EXECUTIVE
Active
Other names
Jackson County Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY KEITH BEAN (DIRECTOR)
(931) 268-2556
Entity
Organization
Contact information
Practice address
316 N. MURRAY STREET, GAINESBORO, TN 38562
(931) 268-2556
(931) 268-3044
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS0000004401
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3525078
—
TN
Enumeration date
06/13/2005
Last updated
06/15/2021
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