1497970511 NPI number — FIRE DISTRICT 2

Table of content: (NPI 1497970511)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497970511 NPI number — FIRE DISTRICT 2

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRE DISTRICT 2
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:
1497970511
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 52261
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IDAHO FALLS
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83405-2261
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-520-7242
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HIGHWAY 31
Provider Second Line Business Practice Location Address:
#15
Provider Business Practice Location Address City Name:
SWAN VALLEY
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-520-7242
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PHILBRICK
Authorized Official First Name:
DEAN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
208-520-7242

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  5710 , 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: 5710 . This is a "EMS LICENSE" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com