Provider Demographics
NPI:1467638577
Name:CITY OF CHELSEA
Entity Type:Organization
Organization Name:CITY OF CHELSEA
Other - Org Name:CITY OF CHELSEA FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SHIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:205-678-6060
Mailing Address - Street 1:PO BOX 361706
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35236-1706
Mailing Address - Country:US
Mailing Address - Phone:205-823-7076
Mailing Address - Fax:205-978-9876
Practice Address - Street 1:160 CHESSER DR
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043-8328
Practice Address - Country:US
Practice Address - Phone:205-678-6060
Practice Address - Fax:205-978-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL154341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051512884OtherBLUE CROSS BLUE SHIELD AL
AL051512884OtherBLUE CROSS BLUE SHIELD AL