Healthcare Provider Details

I. General information

NPI: 1689373664
Provider Name (Legal Business Name): WEST BEND/BETHEL VOLUNTEER FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 02/28/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5630 WEST BEND RD
COFFEEVILLE AL
36524
US

IV. Provider business mailing address

PO BOX 368
COFFEEVILLE AL
36524-0368
US

V. Phone/Fax

Practice location:
  • Phone: 251-769-8227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW MILSTEAD
Title or Position: FIRE CHIEF/PARAMEDIC
Credential: NRP, FP-C
Phone: 251-769-8227