Basic Information
Provider Information
NPI: 1962032185
EntityType: 2
ReplacementNPI:  
OrganizationName: BYERS FIRE PROTECTION DISTRICT NO 9
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 9150
Address2:  
City: PADUCAH
State: KY
PostalCode: 420029150
CountryCode: US
TelephoneNumber: 2707449600
FaxNumber: 2707448642
Practice Location
Address1: 100 NORTH MAIN STREET
Address2:  
City: BYERS
State: CO
PostalCode: 80103
CountryCode: US
TelephoneNumber: 3038225208
FaxNumber: 2707448642
Other Information
ProviderEnumerationDate: 01/16/2020
LastUpdateDate: 11/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WILLIAMS
AuthorizedOfficialFirstName: KAREN
AuthorizedOfficialMiddleName: ANN
AuthorizedOfficialTitleorPosition: BATTALION CHIEF
AuthorizedOfficialTelephone: 3038225208
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 11/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3416L0300X  Y Transportation ServicesAmbulanceLand Transport

ID Information
IDTypeStateIssuerDescription
900016686505CO MEDICAID


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