Basic Information
| Provider Information | |||||||||
| NPI: | 1902919855 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BIG SANDY FIRE PROTECTION DISTRICT | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | SIMLA VOLUNTEER FIRE DEPARTMENT | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 511 COLORADO AVE | ||||||||
| Address2: | |||||||||
| City: | CALHAN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 808088699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193479309 | ||||||||
| FaxNumber: | 7193479311 | ||||||||
| Practice Location | |||||||||
| Address1: | 219 SIOUX AVE | ||||||||
| Address2: | |||||||||
| City: | SIMLA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 808350161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195412883 | ||||||||
| FaxNumber: | 7195413148 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 09/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | MARKLE | ||||||||
| AuthorizedOfficialFirstName: | PETER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 7195412883 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 341600000X | Y | Transportation Services | Ambulance |
No ID Information.