Healthcare Provider Details

I. General information

NPI: 1437697422
Provider Name (Legal Business Name): PLEASANT VALLEY FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 288
YOUNG AZ
85554-0303
US

IV. Provider business mailing address

PO BOX 303
YOUNG AZ
85554
US

V. Phone/Fax

Practice location:
  • Phone: 623-207-7100
  • Fax:
Mailing address:
  • Phone: 623-207-7100
  • 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: ATHENE LOLLMAN
Title or Position: ADMIN
Credential:
Phone: 623-207-7100