1467461210 NPI number — TOWN OF LIVINGSTON

Table of content: (NPI 1467461210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467461210 NPI number — TOWN OF LIVINGSTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF LIVINGSTON
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:
CITY OF LIVINGSTON AMBULANCE SERV
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:
1467461210
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/17/2007
NPI Reactivation Date:
09/13/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVINGSTON
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35470-0408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-652-2505
Provider Business Mailing Address Fax Number:
205-652-9772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1304 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35470-5408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-652-2505
Provider Business Practice Location Address Fax Number:
205-652-9772
Provider Enumeration Date:
08/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DIAL
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CITY ADMINISTRATOR
Authorized Official Telephone Number:
205-652-2505

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  294 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 51051487 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 200060102 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 406590002 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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