1467638577 NPI number — CITY OF CHELSEA

Table of content: (NPI 1467638577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467638577 NPI number — CITY OF CHELSEA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF CHELSEA
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 CHELSEA FIRE DEPARTMENT
Provider Other Organization Name Type Code:
5
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:
1467638577
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/05/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 361706
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35236-1706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-823-7076
Provider Business Mailing Address Fax Number:
205-978-9876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
160 CHESSER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHELSEA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35043-8328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-678-6060
Provider Business Practice Location Address Fax Number:
205-978-9876
Provider Enumeration Date:
01/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SHIRLEY
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
WAYNE
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
205-678-6060

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  154 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 154 , 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: 051512884 . This is a "BLUE CROSS BLUE SHIELD AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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