1619154572 NPI number — HICKAM FIRE EMERGENCY SERVICES

Table of content: (NPI 1619154572)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619154572 NPI number — HICKAM FIRE EMERGENCY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HICKAM FIRE EMERGENCY SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HICKAM FIRE DEPARTMENT
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619154572
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
345 MAMIYA AVE
Provider Second Line Business Mailing Address:
HICKAM FIRE DEPARTMENT
Provider Business Mailing Address City Name:
HICKAM
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96853-5233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-449-8131
Provider Business Mailing Address Fax Number:
808-449-8199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
345 MAMIYA AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HICKAM
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96853-5233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-449-8131
Provider Business Practice Location Address Fax Number:
808-449-8199
Provider Enumeration Date:
01/23/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GARRIGAN
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
MATTHEW
Authorized Official Title or Position:
ASSISTANT FIRE CHIEF
Authorized Official Telephone Number:
808-449-8131

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)