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General NPI Number Information
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NPI Number | 1194911099
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Entity Type | Organization
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Legal Business Name | CITY OF FAIRFAX
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 4081 UNIVERSITY DR STE 400
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City | FAIRFAX
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State | VA
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Zip | 22030-3407
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Country | US
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Telephone | 703-385-7940
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Fax | 703-273-9257
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Provider Business Mailing Address
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Address Line | PO BOX 5211 DEPT # 116256
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City | BINGHAMTON
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State | NY
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Zip | 13902-5211
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Country | US
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Telephone | 703-385-7940
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Fax | 703-273-9257
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | JOHN O'NEAL
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Credential |
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Telephone | 937-291-2892
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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 | 72
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License Number State | VA
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