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General NPI Number Information
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NPI Number | 1003114869
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Entity Type | Organization
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Legal Business Name | FLAGLER COUNTY TAX COLLECTOR AMBULANCE
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 1769 E. MOODY BLVD. BLDG 2 SUITE 102
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City | BUNNELL
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State | FL
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Zip | 32110-5991
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Country | US
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Telephone | 386-313-4160
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Fax | 386-313-4169
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Provider Business Mailing Address
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Address Line | 1769 E MOODY BLVD BLDG 2 POST OFFICE BOX 896
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City | BUNNELL
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State | FL
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Zip | 32110-5991
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Country | US
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Telephone | 386-313-4160
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Fax | 386-313-4169
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Authorized Official
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Title or Position | FLAGLER COUNTY TAX COLLECTOR
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Name | MRS. SUZANNE JOHNSTON
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Credential | C.F.C.
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Telephone | 386-313-4160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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