Provider Demographics
NPI:1285257105
Name:CITY OF PERRVILLE CITY RECORDERS OFFICE
Entity type:Organization
Organization Name:CITY OF PERRVILLE CITY RECORDERS OFFICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:TILLMAN
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-658-0548
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72126-0116
Mailing Address - Country:US
Mailing Address - Phone:501-889-2862
Mailing Address - Fax:
Practice Address - Street 1:512 6TH ST
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:AR
Practice Address - Zip Code:72126
Practice Address - Country:US
Practice Address - Phone:501-889-5016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
No3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty