Basic Information
| Provider Information | |||||||||
| NPI: | 1508496308 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CITY OF STEAMBOAT SPRINGS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 775088 | ||||||||
| Address2: | |||||||||
| City: | STEAMBOAT SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804775088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708797179 | ||||||||
| FaxNumber: | 2707448642 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 PINE GROVE ROAD | ||||||||
| Address2: | |||||||||
| City: | STEAMBOAT SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80487 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708797170 | ||||||||
| FaxNumber: | 2707448642 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2020 | ||||||||
| LastUpdateDate: | 01/21/2020 | ||||||||
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| AuthorizedOfficialLastName: | RINGER | ||||||||
| AuthorizedOfficialFirstName: | CHRISTINA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | ACCOUNTANT | ||||||||
| AuthorizedOfficialTelephone: | 9708718234 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | Y | Transportation Services | Ambulance | Land Transport |
ID Information
| ID | Type | State | Issuer | Description | 9000157464 | 05 | CO | MEDICAID |