Provider Demographics
NPI:1528517885
Name:JACKSONS TRANSPORTAION SERVICE
Entity type:Organization
Organization Name:JACKSONS TRANSPORTAION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ELISHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-729-8792
Mailing Address - Street 1:767 POST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-2309
Mailing Address - Country:US
Mailing Address - Phone:585-729-8792
Mailing Address - Fax:
Practice Address - Street 1:767 POST AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-2309
Practice Address - Country:US
Practice Address - Phone:585-729-8792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351508972344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi