Provider Demographics
NPI:1174544340
Name:JACKSON TWP VOL FIRE COMPANY
Entity type:Organization
Organization Name:JACKSON TWP VOL FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-241-1221
Mailing Address - Street 1:176 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:MINERAL POINT
Mailing Address - State:PA
Mailing Address - Zip Code:15942-5831
Mailing Address - Country:US
Mailing Address - Phone:143-223-1558
Mailing Address - Fax:814-322-1572
Practice Address - Street 1:176 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:MINERAL POINT
Practice Address - State:PA
Practice Address - Zip Code:15942-5831
Practice Address - Country:US
Practice Address - Phone:814-322-3155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA060603416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016394500002Medicaid
PA590010988OtherRAILROAD MEDICARE
PA246885OtherHIGHMARK
PA246885OtherHIGHMARK