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General NPI Number Information
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NPI Number | 1194110791
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Entity Type | Organization
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Legal Business Name | CITY OF SURPRISE
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 14250 W STATLER PLZ STE 101
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City | SURPRISE
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State | AZ
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Zip | 85374-7473
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Country | US
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Telephone | 623-222-5000
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Fax | 623-222-5001
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Provider Business Mailing Address
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Address Line | DEPT # 880109 PO BOX 29650
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City | PHOENIX
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State | AZ
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Zip | 85038-9650
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Country | US
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Telephone | 623-222-1000
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Fax | 623-222-5001
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. TOM ABBOTT
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Credential |
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Telephone | 623-222-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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