Provider Demographics
NPI:1467461210
Name:TOWN OF LIVINGSTON
Entity Type:Organization
Organization Name:TOWN OF LIVINGSTON
Other - Org Name:CITY OF LIVINGSTON AMBULANCE SERV
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIAL
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:205-652-2505
Mailing Address - Street 1:PO BOX W
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:AL
Mailing Address - Zip Code:35470-0408
Mailing Address - Country:US
Mailing Address - Phone:205-652-2505
Mailing Address - Fax:205-652-9772
Practice Address - Street 1:1304 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:AL
Practice Address - Zip Code:35470-5408
Practice Address - Country:US
Practice Address - Phone:205-652-2505
Practice Address - Fax:205-652-9772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2017-05-04
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-09-13
Provider Licenses
StateLicense IDTaxonomies
AL2943416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51051487OtherBLUE CROSS
AL200060102Medicaid
AL406590002OtherMEDICARE RAILROAD
000051487Medicare PIN