Provider Demographics
NPI:1841487766
Name:TOWN OF CHELSEA
Entity type:Organization
Organization Name:TOWN OF CHELSEA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-822-0532
Mailing Address - Street 1:PO BOX 361706
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35236-1706
Mailing Address - Country:US
Mailing Address - Phone:205-822-0532
Mailing Address - Fax:205-978-9876
Practice Address - Street 1:104 CHESSER DRIVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043
Practice Address - Country:US
Practice Address - Phone:205-678-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1543416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051512884OtherBLUE CROSS / BLUE SHIELD
AL051512884OtherBLUE CROSS / BLUE SHIELD