Healthcare Provider Details

I. General information

NPI: 1316572712
Provider Name (Legal Business Name): GIRDWOOD FIRE AND RESCUE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 EGLOFF DR
GIRDWOOD AK
99587-9958
US

IV. Provider business mailing address

PO BOX 915
GIRDWOOD AK
99587-0915
US

V. Phone/Fax

Practice location:
  • Phone: 907-783-2511
  • Fax: 907-783-3212
Mailing address:
  • Phone: 907-783-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MANCH GARHART
Title or Position: DEPUTY CHIEF
Credential:
Phone: 907-783-2511