Basic Information
Provider Information
NPI: 1871573006
EntityType: 2
ReplacementNPI:  
OrganizationName: FLORENCE VOLUNTEER FIRE DEPARTMENT
LastName:  
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Mailing Information
Address1: 2233 E MAIN ST
Address2: BUSINESS OPTIONS MEDICAL BILLING
City: MONTROSE
State: CO
PostalCode: 814013831
CountryCode: US
TelephoneNumber: 9702493700
FaxNumber: 9704978410
Practice Location
Address1: 300 W MAIN ST
Address2:  
City: FLORENCE
State: CO
PostalCode: 812261426
CountryCode: US
TelephoneNumber: 7197843611
FaxNumber: 7197842076
Other Information
ProviderEnumerationDate: 01/23/2006
LastUpdateDate: 10/03/2016
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: MCWILLIAMS
AuthorizedOfficialFirstName: GARY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF
AuthorizedOfficialTelephone: 7197843611
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3416L0300X  Y Transportation ServicesAmbulanceLand Transport

ID Information
IDTypeStateIssuerDescription
59001537001 RAILROAD WORKERS MEDICAREOTHER
61818430001 DEPT OF LABOR FEDERAL WORKERS COMPENSATION (FECA, BLACK LUNG, ENERGY)OTHER
3507654205CO MEDICAID


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