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General NPI Number Information
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NPI Number | 1215095088
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Entity Type | Organization
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Legal Business Name | CITY OF GOODWATER/AMB SRV
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 55 MAIN ST.
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City | GOODWATER
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State | AL
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Zip | 35072
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Country | US
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Telephone | 256-839-5521
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 45
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City | GOODWATER
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State | AL
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Zip | 35072-0045
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Country | US
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Telephone | 256-839-5521
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Fax | 256-839-5663
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Authorized Official
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Title or Position | ASST CHIEF
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Name | MR. ELMORE UNBEHANT
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Credential |
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Telephone | 256-839-5521
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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 | 246
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License Number State | AL
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