1891790424 NPI number — CITY OF POMPANO BEACH

Table of content: (NPI 1891790424)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891790424 NPI number — CITY OF POMPANO BEACH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF POMPANO 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:
Provider Other Organization Name Type Code:
6
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:
1891790424
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 978597
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75397-8597
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-786-4510
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 W ATLANTIC BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POMPANO BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33060-6099
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-786-4510
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GALGANO
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT CHIEF OF EMS
Authorized Official Telephone Number:
754-224-8457

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  3147 , 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: 400002100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590009481 . This is a "R/R MEDICARE PROVIDER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 400002100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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