Healthcare Provider Details

I. General information

NPI: 1033240718
Provider Name (Legal Business Name): CITY OF CARROLLTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 10/24/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 E JACKSON RD
CARROLLTON TX
75006-1737
US

IV. Provider business mailing address

PO BOX 115125
CARROLLTON TX
75011
US

V. Phone/Fax

Practice location:
  • Phone: 972-466-4746
  • Fax: 972-389-9523
Mailing address:
  • Phone: 972-466-4746
  • Fax: 972-389-9523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number057012
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY GLENN
Title or Position: CHIEF
Credential:
Phone: 972-466-3070