VILLAGE OF SOUTH JACKSONVILLE (NPI# 1245488857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245488857 |
| Entity Type | Organization |
| Organization Name | VILLAGE OF SOUTH JACKSONVILLE |
| Practice Address |
301 Dewey Dr Jacksonville IL 62650-3206 |
| Mailing Address |
Po Box 42 Manchester IL 62663-0042 |
| Practice Telephone | 2172454803 |
| Mailing Telephone | 2175874761 |
| Mailing Fax Number | 2175872101 |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2008-12-30 |
| Authorized Official Name | MR. DAVID A HICKOX (FIRE CHIEF) |
| Authorized Official Telephone | 2172454803 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
341600000X | IL | Transportation Services |
| Street Address |
301 DEWEY DR |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-3206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568008977 | Ameripro Ems of Florida, LLC | Ambulance | 4810 Executive Park Ct Ste 112, Jacksonville, FL 32216-6018 | 2019-11-20 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1841763984 | Kindred Care Ems LLC | Ambulance | 6824 Norwood Ave, Jacksonville, FL 32208-4471 | 2019-01-10 |
| 1477942050 | Jax Patient Care | Ambulance | 100 Wharfside Way # A, Jacksonville, FL 32207-8104 | 2015-01-20 |
| 1013070382 | Herbert Steven Pridgen | Ambulance | 705 Grants Creek Rd, Jacksonville, NC 28546-9644 | 2006-12-18 |
| 1679662886 | Ambulance Service, Inc. | Ambulance | 5995 Philips Hwy, Jacksonville, FL 32216-5916 | 2006-10-12 |
| 1720027147 | County of Onslow | Ambulance | 1180 Commons Dr N, Jacksonville, NC 28546-6965 | 2006-06-05 |
| 1932153335 | Century Ambulance Service, Inc. | Ambulance | 2110 Herschel St, Jacksonville, FL 32204-3820 | 2006-05-20 |
| 1902895055 | City of Jacksonville | Ambulance | 900 N Redmond Rd, Jacksonville, AR 72076-3623 | 2005-10-20 |
| 1730188673 | City of Jacksonville | Ambulance | 506 Chinabee Ave Se, Jacksonville, AL 36265-2881 | 2005-07-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
Please comment or provide details below to improve the information on VILLAGE OF SOUTH JACKSONVILLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.