Provider Demographics
NPI:1881319507
Name:CITY OF RUSSELLVILLE OFFICE OF CITY
Entity type:Organization
Organization Name:CITY OF RUSSELLVILLE OFFICE OF CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION CHIEF OF EMS
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:479-968-2332
Mailing Address - Street 1:107 N EL PASO AVE
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-3719
Mailing Address - Country:US
Mailing Address - Phone:479-968-2332
Mailing Address - Fax:479-967-2087
Practice Address - Street 1:107 N EL PASO AVE
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-3719
Practice Address - Country:US
Practice Address - Phone:479-968-2332
Practice Address - Fax:479-967-2087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance