Healthcare Provider Details

I. General information

NPI: 1467461210
Provider Name (Legal Business Name): TOWN OF LIVINGSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 05/04/2017
Certification Date:
Deactivation Date: 07/17/2007
Reactivation Date: 09/13/2007

III. Provider practice location address

1304 N WASHINGTON ST
LIVINGSTON AL
35470-5408
US

IV. Provider business mailing address

PO BOX W
LIVINGSTON AL
35470-0408
US

V. Phone/Fax

Practice location:
  • Phone: 205-652-2505
  • Fax: 205-652-9772
Mailing address:
  • Phone: 205-652-2505
  • Fax: 205-652-9772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number294
License Number StateAL

VIII. Authorized Official

Name: MR. JAMES C DIAL III
Title or Position: CITY ADMINISTRATOR
Credential:
Phone: 205-652-2505