1437106044 NPI number — TOWN OF ATLANTIC BEACH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437106044 NPI number — TOWN OF ATLANTIC BEACH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF ATLANTIC BEACH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ATLANTIC BEACH FIRE DEPARTMENT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437106044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTIC BEACH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28512-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-726-7361
Provider Business Mailing Address Fax Number:
252-726-1804

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
125 W FORT MACON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTIC BEACH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28512-5301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-726-7361
Provider Business Practice Location Address Fax Number:
252-726-1804
Provider Enumeration Date:
05/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ARTHUR
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
CASEY
Authorized Official Title or Position:
DUPTY CHIEF
Authorized Official Telephone Number:
252-726-7361

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3406755 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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