Provider Demographics
NPI:1770509945
Name:CITY OF EUREKA SPRINGS
Entity Type:Organization
Organization Name:CITY OF EUREKA SPRINGS
Other - Org Name:EUREKA SPRINGS FIRE DEPARMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:479-253-9616
Mailing Address - Street 1:146 E VAN BUREN
Mailing Address - Street 2:
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632-8800
Mailing Address - Country:US
Mailing Address - Phone:479-253-9616
Mailing Address - Fax:479-253-9006
Practice Address - Street 1:146 E VAN BUREN
Practice Address - Street 2:
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632-8800
Practice Address - Country:US
Practice Address - Phone:479-253-9616
Practice Address - Fax:479-253-9006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR01343416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR101378715Medicaid
AR101378715Medicaid