Healthcare Provider Details

I. General information

NPI: 1770287898
Provider Name (Legal Business Name): CITY OF LEEDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 PARK DR
LEEDS AL
35094-1800
US

IV. Provider business mailing address

PO BOX 361706
BIRMINGHAM AL
35236-1706
US

V. Phone/Fax

Practice location:
  • Phone: 205-577-1566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KYLE A SHELL
Title or Position: CAPTAIN
Credential:
Phone: 205-823-7076