Healthcare Provider Details

I. General information

NPI: 1467873851
Provider Name (Legal Business Name): WILLIAMSON VALLEY FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2014
Last Update Date: 01/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15450 N WILLIAMSON VALLEY RD
PRESCOTT AZ
86305-5701
US

IV. Provider business mailing address

PO BOX 747
WHEELING IL
60090-0747
US

V. Phone/Fax

Practice location:
  • Phone: 928-717-2304
  • Fax: 928-717-1994
Mailing address:
  • Phone: 800-244-2345
  • Fax: 800-329-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number135
License Number StateAZ

VIII. Authorized Official

Name: BRYAN SMITH
Title or Position: FIRE CHIEF
Credential:
Phone: 928-717-2304