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General NPI Number Information
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NPI Number | 1346273455
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Entity Type | Organization
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Legal Business Name | COUNTY OF BAKER
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 12/06/2019
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Provider Practice Location Address
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Address Line | 1190 W MACCLENNY AVE
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City | MACCLENNY
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State | FL
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Zip | 32063-0958
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Country | US
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Telephone | 904-259-0229
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Fax | 904-259-3923
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Provider Business Mailing Address
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Address Line | 1190 W MACCLENNY AVE
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City | MACCLENNY
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State | FL
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Zip | 32063-4458
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Country | US
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Telephone | 904-259-0229
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Fax |
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | TREVOR NELSON
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Credential |
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Telephone | 904-259-0229
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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 | 2711
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License Number State | FL
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