MEDICARE: SMITHS STATION FIRE AND RESCUE

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	1124	AL

General Provider Information

NPI Number	:	1750898946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITHS STATION FIRE AND RESCUE

Provider Business Mailing Address
First Line	:	50 LEE ROAD 430
Second Line	:
City	:	SMITHS STATION
State	:	AL
Zip	:	36877-2600
Country	:	US
Telephone Number	:	334-947-0911
Fax Number	:	334-947-0912

Provider Business Practice Location Address
First Line	:	50 LEE ROAD 430
Second Line	:
City	:	SMITHS STATION
State	:	AL
Zip	:	36877-2600
Country	:	US
Telephone Number	:	334-947-0911
Fax Number	:	334-947-0912

Authorized Official
Title or Position	:	CHIEF
Name	:	BLAKE A GREEN JR.
Credential	:
Telephone Number	:	334-947-0913

Provider Enumeration Date	:	01/09/2018
Last Update Date	:	08/08/2024

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