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General NPI Number Information
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NPI Number | 1619461977
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Entity Type | Organization
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Legal Business Name | NORTHEAST MIDLAND COUNTY VOLUNTEER FIRE DEPARTMENT
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 3810 N COUNTY ROAD 1130
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City | MIDLAND
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State | TX
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Zip | 79705
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Country | US
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Telephone | 432-695-6879
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10005
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City | MIDLAND
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State | TX
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Zip | 79702-7005
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Country | US
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Telephone | 432-695-6879
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING REP
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Name | APRIL COPELAND
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Credential |
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Telephone | 806-787-6764
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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 | 1000966
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License Number State | TX
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