Provider Demographics
NPI:1679613749
Name:TOWN OF QUITMAN
Entity Type:Organization
Organization Name:TOWN OF QUITMAN
Other - Org Name:QUITMAN RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARTHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-589-3312
Mailing Address - Street 1:PO BOX 141
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:AR
Mailing Address - Zip Code:72131-0141
Mailing Address - Country:US
Mailing Address - Phone:501-589-3312
Mailing Address - Fax:501-589-3022
Practice Address - Street 1:9 BEE BRANCH RD
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:AR
Practice Address - Zip Code:72131-8206
Practice Address - Country:US
Practice Address - Phone:501-589-3312
Practice Address - Fax:501-589-3022
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF QUITMAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-07
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR265341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR109838715Medicaid
AR109838715Medicaid