Healthcare Provider Details

I. General information

NPI: 1588831267
Provider Name (Legal Business Name): QUARTZSITE FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E TYSON STREET
QUARTZSITE AZ
85346-1889
US

IV. Provider business mailing address

PO BOX 1889
QUARTZSITE AZ
85346-1889
US

V. Phone/Fax

Practice location:
  • Phone: 928-927-6556
  • Fax: 928-927-4277
Mailing address:
  • Phone: 928-927-6556
  • Fax: 928-927-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN DAVID HESS
Title or Position: CHIEF
Credential: CEP
Phone: 928-927-6556