Provider Demographics
NPI:1245531482
Name:TOWN OF INDIAN RIVER SHORES
Entity type:Organization
Organization Name:TOWN OF INDIAN RIVER SHORES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TOWN TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHRISTMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-231-1771
Mailing Address - Street 1:6001 HIGHWAY A1A
Mailing Address - Street 2:
Mailing Address - City:INDIAN RIVER SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:32963-1014
Mailing Address - Country:US
Mailing Address - Phone:772-231-2451
Mailing Address - Fax:772-231-2444
Practice Address - Street 1:6001 HIGHWAY A1A
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER SHORES
Practice Address - State:FL
Practice Address - Zip Code:32963-1014
Practice Address - Country:US
Practice Address - Phone:772-231-2451
Practice Address - Fax:772-231-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3416L0300X
FL31033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport