Provider Demographics
NPI:1871693721
Name:CITY OF EL DORADO OFFICE OF CITY CLERK
Entity type:Organization
Organization Name:CITY OF EL DORADO OFFICE OF CITY CLERK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-881-4855
Mailing Address - Street 1:PO BOX 2170
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71731-2170
Mailing Address - Country:US
Mailing Address - Phone:870-881-4855
Mailing Address - Fax:870-881-8989
Practice Address - Street 1:204 N WEST AVE
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-5622
Practice Address - Country:US
Practice Address - Phone:870-881-4855
Practice Address - Fax:870-881-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5813416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR590083094OtherRAILROAD MEDICARE
AR106089715Medicaid
AR47124Medicare ID - Type UnspecifiedMEDICARE