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Organization

CITY OF GOODWATER/AMB SRV

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ELMORE UNBEHANT (ASST CHIEF)
(256) 839-5521
Entity
Organization

Contact information

Practice address
55 MAIN ST., GOODWATER, AL 35072
(256) 839-5521
Mailing address
PO BOX 45, GOODWATER, AL 35072-0045
(256) 839-5521
(256) 839-5663

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
246
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000051665
AL
01
51051665
BLUECROSS BLUESHIELD
AL
01
590012097
RAILROAD MEDICARE
AL
Enumeration date
12/05/2006
Last updated
08/21/2007
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