Provider Demographics
NPI:1346568003
Name:CITY OF BOAZ
Entity Type:Organization
Organization Name:CITY OF BOAZ
Other - Org Name:BOAZ FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-593-8488
Mailing Address - Street 1:201 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-1907
Mailing Address - Country:US
Mailing Address - Phone:256-593-8488
Mailing Address - Fax:256-840-5353
Practice Address - Street 1:201 BROWN ST
Practice Address - Street 2:
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35957-1907
Practice Address - Country:US
Practice Address - Phone:256-593-8488
Practice Address - Fax:256-840-5353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0909143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport