Healthcare Provider Details

I. General information

NPI: 1750898946
Provider Name (Legal Business Name): SMITHS STATION FIRE AND RESCUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2018
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 LEE ROAD 430
SMITHS STATION AL
36877-2600
US

IV. Provider business mailing address

50 LEE ROAD 430
SMITHS STATION AL
36877-2600
US

V. Phone/Fax

Practice location:
  • Phone: 334-947-0911
  • Fax: 334-947-0912
Mailing address:
  • Phone: 334-947-0911
  • Fax: 334-947-0912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1124
License Number StateAL

VIII. Authorized Official

Name: BLAKE A GREEN JR.
Title or Position: CHIEF
Credential:
Phone: 334-947-0913