Provider Demographics
NPI:1437106044
Name:TOWN OF ATLANTIC BEACH
Entity Type:Organization
Organization Name:TOWN OF ATLANTIC BEACH
Other - Org Name:ATLANTIC BEACH FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DUPTY CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CASEY
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-726-7361
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28512-0010
Mailing Address - Country:US
Mailing Address - Phone:252-726-7361
Mailing Address - Fax:252-726-1804
Practice Address - Street 1:125 W FORT MACON RD
Practice Address - Street 2:
Practice Address - City:ATLANTIC BEACH
Practice Address - State:NC
Practice Address - Zip Code:28512-5301
Practice Address - Country:US
Practice Address - Phone:252-726-7361
Practice Address - Fax:252-726-1804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406755Medicaid
NC2783076Medicare PIN
NC2783076Medicare ID - Type Unspecified