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General NPI Number Information
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NPI Number | 1982640397
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Entity Type | Organization
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Legal Business Name | COUNTY OF JACKSON OFFICE CLERK BOARD COUNTY COMMISSIONERS
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 2864 MADISON STREET
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City | MARIANNA
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State | FL
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Zip | 32448-4610
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Country | US
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Telephone | 850-718-0000
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Fax | 850-718-0048
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Provider Business Mailing Address
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Address Line | 2864 MADISON STREET
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City | MARIANNA
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State | FL
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Zip | 32448-4610
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Country | US
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Telephone | 850-718-0000
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Fax | 850-718-0048
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDA GRAY
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Credential |
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Telephone | 850-718-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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