Healthcare Provider Details

I. General information

NPI: 1528071057
Provider Name (Legal Business Name): ROCKY RIDGE FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 METROPOLITAN WAY
BIRMINGHAM AL
35243-2943
US

IV. Provider business mailing address

2911 METROPOLITAN WAY
BIRMINGHAM AL
35243-2943
US

V. Phone/Fax

Practice location:
  • Phone: 205-822-0532
  • Fax: 205-978-9876
Mailing address:
  • Phone: 205-822-0532
  • Fax: 205-978-9876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number356
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number356
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number356
License Number StateAL

VIII. Authorized Official

Name: MR. JON LORD
Title or Position: FIRE CHIEF
Credential: EMT-I
Phone: 205-822-0532