1023157211 NPI number — TOWN OF CENTER FIRE PROTECTION

Table of content: (NPI 1023157211)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023157211 NPI number — TOWN OF CENTER FIRE PROTECTION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF CENTER FIRE PROTECTION
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:
Provider Other Organization Name Type Code:
6
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:
1023157211
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40813 TAPADERO CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELIZABETH
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80107-9215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-680-9860
Provider Business Mailing Address Fax Number:
303-617-0135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
360 EAST 8TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-680-9860
Provider Business Practice Location Address Fax Number:
303-617-0135
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BREWER
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
Authorized Official Title or Position:
BOARD SECRETARY
Authorized Official Telephone Number:
719-754-3598

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  M00534316 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 06001127 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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