1639180979 NPI number — BOARD OF COUNTY COMMISSIONERS COUNTY OF MONROE

Table of content: (NPI 1639180979)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639180979 NPI number — BOARD OF COUNTY COMMISSIONERS COUNTY OF MONROE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOARD OF COUNTY COMMISSIONERS COUNTY OF MONROE
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:
MONROE COUNTY EMS
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:
1639180979
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11713
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34101-1713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
490 E 63RD ST
Provider Second Line Business Practice Location Address:
RM 170
Provider Business Practice Location Address City Name:
MARATHON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33050-4720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-289-6010
Provider Business Practice Location Address Fax Number:
305-289-6337
Provider Enumeration Date:
08/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CALLAHAN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
305-289-6088

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  3223 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 087736100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590004509 . This is a "RAILROAD PROVIDER ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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