MEDICARE: NORTH MONTGOMERY VOLUNTEER FIRE DEPTARTMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1538498068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH MONTGOMERY VOLUNTEER FIRE DEPTARTMENT

Provider Business Mailing Address
First Line	:	3670 COOSADA FERRY RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36110-1034
Country	:	US
Telephone Number	:	334-269-6202
Fax Number	:

Provider Business Practice Location Address
First Line	:	3670 COOSADA FERRY RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36110-1034
Country	:	US
Telephone Number	:	334-269-6202
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. STACI BROOKS
Credential	:
Telephone Number	:	334-269-6202

Provider Enumeration Date	:	12/11/2009
Last Update Date	:	12/11/2009

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Directions to “NORTH MONTGOMERY VOLUNTEER FIRE DEPTARTMENT ” Practice Location

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