1467548719 NPI number — CITY OF VALLEY EMS

Table of content: (NPI 1467548719)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467548719 NPI number — CITY OF VALLEY EMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF VALLEY EMS
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:
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:
1467548719
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 186
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VALLEY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36854
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-756-5238
Provider Business Mailing Address Fax Number:
334-756-5761

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 FOB JAMES DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALLEY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-756-5238
Provider Business Practice Location Address Fax Number:
334-756-5761
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HAMIL
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
EMS DIRECTOR
Authorized Official Telephone Number:
334-756-5238

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  174 , 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: 000053843 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000238939X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051053843 . This is a "BLUE CROSS OF AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051053843 . 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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