1780610287 NPI number — COUNTY OF ALACHUA BOARD OF COUNTY COMMISSIONERS

Table of content: (NPI 1780610287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780610287 NPI number — COUNTY OF ALACHUA BOARD OF COUNTY COMMISSIONERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF ALACHUA BOARD OF COUNTY COMMISSIONERS
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:
ALACHUA COUNTY FIRE RESCUE
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:
1780610287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5038
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32627-5038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-384-3150
Provider Business Mailing Address Fax Number:
352-384-3157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
911 SE 5 ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32601-8011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-384-3150
Provider Business Practice Location Address Fax Number:
352-384-3157
Provider Enumeration Date:
06/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
THEUS
Authorized Official First Name:
HAROLD
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR/CHIEF, FIRE RESCUE
Authorized Official Telephone Number:
352-384-3126

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  2662 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: US DEPT OF LABOR . This is a "162904100" identifier . This identifiers is of the category "OTHER".
  • Identifier: 088173200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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