=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154326445
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOWN OF ARITION RESCUE SQUAD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/14/2005
-----------------------------------------------------
Last Update Date | 09/17/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 837 E MAIN ST
-----------------------------------------------------
City | ARITON
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36311-5025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-762-2399
-----------------------------------------------------
Fax | 334-762-2399
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 183
-----------------------------------------------------
City | ARITON
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36311-0183
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-762-2399
-----------------------------------------------------
Fax | 334-762-2399
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY-TREASURY
-----------------------------------------------------
Name | MR. EDSEL EUGENE BONDS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 334-762-2399
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 122
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------