Healthcare Provider Details

I. General information

NPI: 1902271448
Provider Name (Legal Business Name): CITY OF LOWELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2015
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 N LINCOLN ST
LOWELL AR
72745-9048
US

IV. Provider business mailing address

216 N LINCOLN ST
LOWELL AR
72745-9048
US

V. Phone/Fax

Practice location:
  • Phone: 479-770-0166
  • Fax: 479-770-6047
Mailing address:
  • Phone: 479-770-0166
  • Fax: 479-770-6047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number126
License Number StateAR

VIII. Authorized Official

Name: MR. MICHAEL MORRIS
Title or Position: FIRE CHIEF
Credential:
Phone: 479-770-0166