1679680292 NPI number — FRANKTOWN FIRE PROTECTION DISTRICT

Table of content: MELISSA ANN ROUSH LPC (NPI 1518504810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679680292 NPI number — FRANKTOWN FIRE PROTECTION DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANKTOWN 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:
Provider Other Organization Name Type Code:
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:
1679680292
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 53
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKTOWN
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80116-0053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-525-9287
Provider Business Mailing Address Fax Number:
303-688-6940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1959 N STATE HIGHWAY 83
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKTOWN
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80116-5052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-688-3811
Provider Business Practice Location Address Fax Number:
303-688-6940
Provider Enumeration Date:
08/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GADZIALA
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
CAROL
Authorized Official Title or Position:
CERTIFIED AMBULANCE CODER
Authorized Official Telephone Number:
303-525-9287

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)

  • Identifier: P00239398 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 06001499 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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