Basic Information
| Provider Information | |||||||||
| NPI: | 1306986104 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SUSSEX POST 8 AMERICAN LEGION GEORGETOWN AMBULANCE SERV | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 128 | ||||||||
| Address2: | |||||||||
| City: | SMYRNA | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199770128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026533557 | ||||||||
| FaxNumber: | 3026533552 | ||||||||
| Practice Location | |||||||||
| Address1: | 406 N FRONT ST | ||||||||
| Address2: | |||||||||
| City: | GEORGETOWN | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199471134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026533557 | ||||||||
| FaxNumber: | 3026533552 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2007 | ||||||||
| LastUpdateDate: | 11/27/2012 | ||||||||
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| AuthorizedOfficialLastName: | BROUGH | ||||||||
| AuthorizedOfficialFirstName: | SHERRI | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 3026533557 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | A93 B93 | DE | Y | Transportation Services | Ambulance | Land Transport |
No ID Information.