1295959328 NPI number — SOUTHERN COLORADO RURAL EMERGENCY MEDICAL SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295959328 NPI number — SOUTHERN COLORADO RURAL EMERGENCY MEDICAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHERN COLORADO RURAL EMERGENCY MEDICAL SERVICES, INC.
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:
1295959328
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7022 COUNTY RD. KK
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANZANOLA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-248-3978
Provider Business Mailing Address Fax Number:
719-263-5683

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7022 COUNTY RD. KK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANZANOLA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81058-9705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-248-3978
Provider Business Practice Location Address Fax Number:
719-263-5683
Provider Enumeration Date:
04/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CHAMBERS
Authorized Official First Name:
BRANDON
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
719-248-3978

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , 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)





Copyright © 2007-2025 www.npivalidator.com