Provider Demographics
NPI:1629099262
Name:CITY OF MONT BELVIEU
Entity Type:Organization
Organization Name:CITY OF MONT BELVIEU
Other - Org Name:MONT BELVIEU FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-576-2213
Mailing Address - Street 1:PO BOX 1048
Mailing Address - Street 2:
Mailing Address - City:MONT BELVIEU
Mailing Address - State:TX
Mailing Address - Zip Code:77580-1048
Mailing Address - Country:US
Mailing Address - Phone:281-576-2021
Mailing Address - Fax:281-385-2194
Practice Address - Street 1:11607 EAGLE DR
Practice Address - Street 2:
Practice Address - City:MONT BELVIEU
Practice Address - State:TX
Practice Address - Zip Code:77580
Practice Address - Country:US
Practice Address - Phone:281-576-2021
Practice Address - Fax:281-385-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36002341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX517821OtherBC/BS OF TEXAS
590015294OtherRAILROAD MEDICARE
TX000546401Medicaid
TX517821Medicare PIN