Healthcare Provider Details

I. General information

NPI: 1881132843
Provider Name (Legal Business Name): ANDERSON VALLEY COMMUNITY SERVICE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14281 HWY 128
BOONVILLE CA
95415
US

IV. Provider business mailing address

PO BOX 398
BOONVILLE CA
95415-0398
US

V. Phone/Fax

Practice location:
  • Phone: 707-895-2020
  • Fax:
Mailing address:
  • Phone: 707-895-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: ANDRES AVILA
Title or Position: FIRE CHIEF
Credential:
Phone: 707-895-2020