Provider Demographics
NPI:1679722664
Name:CITY OF TUCKERMAN RECORDER TREASURER
Entity type:Organization
Organization Name:CITY OF TUCKERMAN RECORDER TREASURER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:WROTEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:CHIEF
Authorized Official - Phone:870-349-5212
Mailing Address - Street 1:PO BOX 641880
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7880
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:402-991-0719
Practice Address - Street 1:201 MAIN STREET
Practice Address - Street 2:
Practice Address - City:TUCKERMAN
Practice Address - State:AR
Practice Address - Zip Code:72473-0779
Practice Address - Country:US
Practice Address - Phone:870-349-5212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR239341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance