Provider Demographics
NPI:1588896260
Name:JAKES BRANCH FIRE AND RESCUE
Entity type:Organization
Organization Name:JAKES BRANCH FIRE AND RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:606-439-4431
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:BULAN
Mailing Address - State:KY
Mailing Address - Zip Code:41722-0065
Mailing Address - Country:US
Mailing Address - Phone:606-439-4431
Mailing Address - Fax:606-439-4431
Practice Address - Street 1:5447 KY HWY 476
Practice Address - Street 2:
Practice Address - City:BULAN
Practice Address - State:KY
Practice Address - Zip Code:41722-0065
Practice Address - Country:US
Practice Address - Phone:606-439-4431
Practice Address - Fax:606-439-4431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP0901013146L00000X
KYB1638227146N00000X
KY45390146N00000X
KY155970101146N00000X
KY5666813146N00000X
KYP0921975146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty