MEDICARE: CITY OF JUNCTION CITY

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	3416L0300X	Land Ambulance	X11394	AR

General Provider Information

NPI Number	:	1710194170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF JUNCTION CITY

Provider Business Mailing Address
First Line	:	207 NORTH MAIN STREET
Second Line	:	PO BOX 787
City	:	JUNCTION CITY
State	:	AR
Zip	:	71749-0787
Country	:	US
Telephone Number	:	870-924-4922
Fax Number	:	870-924-4023

Provider Business Practice Location Address
First Line	:	207 NORTH MAIN STREET
Second Line	:
City	:	JUNCTION CITY
State	:	AR
Zip	:	71749-0787
Country	:	US
Telephone Number	:	870-924-4922
Fax Number	:	870-924-4023

Authorized Official
Title or Position	:	MAYOR,CITY OF JUNCTION CITY, AR
Name	:	MR. LARRY CARTER
Credential	:
Telephone Number	:	870-924-4922

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	01/13/2012

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Directions to “CITY OF JUNCTION CITY ” Practice Location

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