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General NPI Number Information
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NPI Number | 1649295551
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Entity Type | Organization
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Legal Business Name | CITY OF FRUITLAND
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 200 S WHITLEY DR
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City | FRUITLAND
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State | ID
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Zip | 83619-2537
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Country | US
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Telephone | 208-452-4421
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Fax | 208-452-6146
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Provider Business Mailing Address
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Address Line | PO BOX 324
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City | FRUITLAND
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State | ID
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Zip | 83619-0324
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Country | US
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Telephone | 208-452-4421
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Fax | 208-452-6146
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Authorized Official
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Title or Position | SUPERVISOR
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Name | RICK WATKINS
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Credential |
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Telephone | 208-452-4421
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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 | 3330
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License Number State | ID
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