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General NPI Number Information
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NPI Number | 1780742379
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Entity Type | Organization
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Legal Business Name | CITY OF ARCHER CITY
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 118 S SYCAMORE
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City | ARCHER CITY
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State | TX
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Zip | 76351
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Country | US
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Telephone | 940-574-2871
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Fax | 940-574-4995
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Provider Business Mailing Address
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Address Line | PO BOX 367
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City | ARCHER CITY
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State | TX
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Zip | 76351-0367
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Country | US
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Telephone | 940-574-2871
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Fax | 940-574-4995
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | MR. CLIFFORD EDMUND FRODYMA
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Credential | PARAMEDIC
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Telephone | 940-574-2871
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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 | 005007
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License Number State | TX
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