1548364789 NPI number — MCCALL FIRE PROTECTION DISTRICT

Table of content: (NPI 1548364789)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548364789 NPI number — MCCALL FIRE PROTECTION DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCCALL FIRE PROTECTION DISTRICT
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:
MCCALL FIRE & EMS
Provider Other Organization Name Type Code:
3
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:
1548364789
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3510
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVERDALE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98383-3510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-394-7010
Provider Business Mailing Address Fax Number:
360-394-7099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 DEINHARD LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCCALL
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83638-4604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-634-7070
Provider Business Practice Location Address Fax Number:
208-634-5360
Provider Enumeration Date:
09/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BILLMIRE
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
208-634-7070

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  #7427 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000010014763 . This is a "BLUE SHIELD" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 0026481 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1540888 . This is a "UNITED MINE WORKERS" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: E0880 . This is a "BLUE CROSS" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 590011274 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".




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