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General NPI Number Information
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NPI Number | 1346568003
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Entity Type | Organization
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Legal Business Name | CITY OF BOAZ
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Dates
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Enumeration Date | 05/05/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 201 BROWN ST
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City | BOAZ
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State | AL
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Zip | 35957-1907
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Country | US
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Telephone | 256-593-8488
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Fax | 256-840-5353
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Provider Business Mailing Address
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Address Line | 201 BROWN ST
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City | BOAZ
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State | AL
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Zip | 35957-1907
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Country | US
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Telephone | 256-593-8488
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Fax | 256-840-5353
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Authorized Official
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Title or Position | CHIEF
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Name | MIKE SPARKS
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Credential |
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Telephone | 256-593-8488
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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 | 090914
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License Number State | AL
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