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General NPI Number Information
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NPI Number | 1619998564
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Entity Type | Organization
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Legal Business Name | THE EAGLE MOUNTAIN VOLUNTEER FIRE DEPARTMENT
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 9500 LIVE OAK LN
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City | FORT WORTH
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State | TX
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Zip | 76179-4061
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Country | US
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Telephone | 866-398-8999
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Fax | 866-724-5995
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Provider Business Mailing Address
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Address Line | 9500 LIVE OAK LN
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City | FORT WORTH
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State | TX
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Zip | 76179-4061
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Country | US
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Telephone | 817-236-8044
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Fax | 817-236-3923
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | MICHAEL BARTON
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Credential |
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Telephone | 817-236-8044
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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 | 220033
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License Number State | TX
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