Provider Demographics
NPI:1003114869
Name:FLAGLER COUNTY TAX COLLECTOR AMBULANCE
Entity Type:Organization
Organization Name:FLAGLER COUNTY TAX COLLECTOR AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FLAGLER COUNTY TAX COLLECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:CFC
Authorized Official - Phone:386-313-4160
Mailing Address - Street 1:1769 E MOODY BLVD BLDG 2
Mailing Address - Street 2:POST OFFICE BOX 896
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-5991
Mailing Address - Country:US
Mailing Address - Phone:386-313-4160
Mailing Address - Fax:386-313-4169
Practice Address - Street 1:1769 E. MOODY BLVD.
Practice Address - Street 2:BLDG 2 SUITE 102
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-5991
Practice Address - Country:US
Practice Address - Phone:386-313-4160
Practice Address - Fax:386-313-4169
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLAGLER COUNTY BOARD OF COUNTY COMMISSIONERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance