Healthcare Provider Details

I. General information

NPI: 1962096552
Provider Name (Legal Business Name): CITY OF IRONDALE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5308 BEACON DR
IRONDALE AL
35210-2820
US

IV. Provider business mailing address

PO BOX 361706
BIRMINGHAM AL
35236-1706
US

V. Phone/Fax

Practice location:
  • Phone: 205-823-7076
  • Fax: 205-978-9876
Mailing address:
  • Phone: 205-823-7076
  • Fax: 205-978-9876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA L MCDANIEL
Title or Position: FIRE CHIEF
Credential:
Phone: 205-823-7076