Provider Demographics
NPI:1588662266
Name:CITY OF BARTLETT
Entity Type:Organization
Organization Name:CITY OF BARTLETT
Other - Org Name:BARTLETT FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF ADMIN OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-385-5536
Mailing Address - Street 1:2939 ALTRURIA RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3861
Mailing Address - Country:US
Mailing Address - Phone:901-385-5536
Mailing Address - Fax:901-385-9917
Practice Address - Street 1:2939 ALTRURIA RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3861
Practice Address - Country:US
Practice Address - Phone:901-385-5536
Practice Address - Fax:901-385-9917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS00000079063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3563597Medicaid