Healthcare Provider Details

I. General information

NPI: 1679613749
Provider Name (Legal Business Name): TOWN OF QUITMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 BEE BRANCH RD
QUITMAN AR
72131-8206
US

IV. Provider business mailing address

PO BOX 141
QUITMAN AR
72131-0141
US

V. Phone/Fax

Practice location:
  • Phone: 501-589-3312
  • Fax: 501-589-3022
Mailing address:
  • Phone: 501-589-3312
  • Fax: 501-589-3022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number265
License Number StateAR

VIII. Authorized Official

Name: MR. CARTHEL PEARCE
Title or Position: MAYOR
Credential:
Phone: 501-589-3312