1912422924 NPI number — CITY OF BUCKEYE

Table of content: (NPI 1912422924)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912422924 NPI number — CITY OF BUCKEYE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF BUCKEYE
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:
BUCKEYE FIRE-MEDICAL RESCUE DEPARTMENT
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:
1912422924
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PADUCAH
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42002-9150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-744-9600
Provider Business Mailing Address Fax Number:
270-744-8642

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21699 W. YUMA RD., STE. 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUCKEYE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-349-6700
Provider Business Practice Location Address Fax Number:
623-349-6750
Provider Enumeration Date:
08/10/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STOCKLEY
Authorized Official First Name:
WILLIAM ''BILL'
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
623-349-6719

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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