MEDICARE: TOWN OF MIDLAND CITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance

General Provider Information

NPI Number	:	1700322815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN OF MIDLAND CITY

Provider Business Mailing Address
First Line	:	PO BOX 69
Second Line	:
City	:	MIDLAND CITY
State	:	AL
Zip	:	36350-0069
Country	:	US
Telephone Number	:	334-983-3591
Fax Number	:	334-983-3514

Provider Business Practice Location Address
First Line	:	1343 HINTON WATERS AVE.
Second Line	:
City	:	MIDLAND CITY
State	:	AL
Zip	:	36350-0069
Country	:	US
Telephone Number	:	334-983-3591
Fax Number	:	334-983-3514

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	MR. KIRBY BERT CHANDLER
Credential	:
Telephone Number	:	334-983-3591

Provider Enumeration Date	:	01/12/2017
Last Update Date	:	10/05/2017

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Directions to “TOWN OF MIDLAND CITY ” Practice Location

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