Provider Demographics
NPI:1750650354
Name:JACKSON EMS
Entity Type:Organization
Organization Name:JACKSON EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:ISAAC
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-732-4526
Mailing Address - Street 1:PO BOX 11374
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-0374
Mailing Address - Country:US
Mailing Address - Phone:678-732-4526
Mailing Address - Fax:
Practice Address - Street 1:2001 MARTIN LUTHER KING JR DR SW STE 406
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-5802
Practice Address - Country:US
Practice Address - Phone:678-705-7959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance