Healthcare Provider Details
I. General information
NPI: 1760482061
Provider Name (Legal Business Name): LUCERNE FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6257 7TH AVE
LUCERNE CA
95458
US
IV. Provider business mailing address
PO BOX 269110
SACRAMENTO CA
95826-9110
US
V. Phone/Fax
- Phone: 707-274-3100
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
C
ROBBINS
Title or Position: FIRE CHIEF
Credential:
Phone: 707-274-3100