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General NPI Number Information
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NPI Number | 1063604148
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Entity Type | Organization
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Legal Business Name | CITY OF MERRILL
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 500 ROOSEVELT STREET
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City | MERRILL
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State | IA
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Zip | 51038-9998
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Country | US
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Telephone | 712-938-2578
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 290184
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City | WETHERSFIELD
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State | CT
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Zip | 06129-0184
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Country | US
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Telephone | 860-257-7080
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Fax | 860-563-3403
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MRS. MARY T GENTILE
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Credential |
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Telephone | 860-257-7080
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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 | 2751000
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License Number State | IA
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