Healthcare Provider Details

I. General information

NPI: 1174569206
Provider Name (Legal Business Name): CITY OF DUMAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 E WATERMAN ST
DUMAS AR
71639
US

IV. Provider business mailing address

P.O. BOX 157
DUMAS AR
71639
US

V. Phone/Fax

Practice location:
  • Phone: 870-382-1131
  • Fax: 870-382-5667
Mailing address:
  • Phone: 870-382-1131
  • Fax: 870-382-5667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number440
License Number StateAR

VIII. Authorized Official

Name: MRS. ERMA J COBURN
Title or Position: EMT DIRECTOR
Credential: EMS DIRECTOR EMT
Phone: 870-382-1131