Provider Demographics
NPI:1336218114
Name:CITY OF CHILDERSBURG
Entity Type:Organization
Organization Name:CITY OF CHILDERSBURG
Other - Org Name:CHILDERSBURG AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AMBULANCE BILLING ACCOUNTS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGBLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-378-7062
Mailing Address - Street 1:122 6TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:CHILDERSBURG
Mailing Address - State:AL
Mailing Address - Zip Code:35044-1646
Mailing Address - Country:US
Mailing Address - Phone:256-378-7062
Mailing Address - Fax:256-598-0006
Practice Address - Street 1:122 6TH AVE SW
Practice Address - Street 2:
Practice Address - City:CHILDERSBURG
Practice Address - State:AL
Practice Address - Zip Code:35044-1646
Practice Address - Country:US
Practice Address - Phone:256-378-7062
Practice Address - Fax:256-598-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0159341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance