Provider Demographics
NPI:1982686424
Name:CITY OF ALEXANDRIA
Entity Type:Organization
Organization Name:CITY OF ALEXANDRIA
Other - Org Name:ALEXANDRIA FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST. FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-724-2195
Mailing Address - Street 1:212 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:IN
Mailing Address - Zip Code:46001-2422
Mailing Address - Country:US
Mailing Address - Phone:765-724-2195
Mailing Address - Fax:765-724-9483
Practice Address - Street 1:212 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:IN
Practice Address - Zip Code:46001-2422
Practice Address - Country:US
Practice Address - Phone:765-724-2195
Practice Address - Fax:765-724-9483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN987780Medicare ID - Type Unspecified