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General NPI Number Information
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NPI Number | 1114033024
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Entity Type | Organization
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Legal Business Name | COUNTY OF MOFFITT
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 114 COLLUM ST
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City | MAYBELL
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State | CO
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Zip | 81640
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Country | US
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Telephone | 970-826-3131
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 84
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City | MAYBELL
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State | CO
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Zip | 81640-0084
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Country | US
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Telephone | 970-826-3131
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Fax |
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Authorized Official
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Title or Position | COORDINATOR
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Name | TOM SUSS
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Credential |
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Telephone | 970-826-3131
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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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