Healthcare Provider Details

I. General information

NPI: 1437157617
Provider Name (Legal Business Name): JACKSON COUNTY AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 MCCAMMON RIDGE RD
MC KEE KY
40447-6320
US

IV. Provider business mailing address

PO BOX 589
MADISONVILLE KY
42431-5011
US

V. Phone/Fax

Practice location:
  • Phone: 606-287-7782
  • Fax: 606-287-4199
Mailing address:
  • Phone: 270-824-8123
  • Fax: 270-824-8140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1407
License Number StateKY

VIII. Authorized Official

Name: MR. CRAIG BOWLES
Title or Position: DIRECTOR / CHIEF OF OPERATIONS
Credential:
Phone: 606-287-7782