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General NPI Number Information
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NPI Number | 1295830388
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Entity Type | Organization
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Legal Business Name | CITY OF GRAPELAND
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 126 SOUTH OAK
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City | GRAPELAND
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State | TX
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Zip | 75844
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Country | US
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Telephone | 936-687-2115
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Fax | 936-687-2799
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Provider Business Mailing Address
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Address Line | PO BOX 567
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City | GRAPELAND
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State | TX
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Zip | 75844-0567
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Country | US
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Telephone | 936-687-2115
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Fax | 936-687-2799
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Authorized Official
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Title or Position | EMS ASSISTANTT CHIEF
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Name | MRS. CHASTITY LORI ANN LEBLANC
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Credential | PARAMEDIC
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Telephone | 936-687-2115
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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 | 113002
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License Number State | TX
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