Healthcare Provider Details

I. General information

NPI: 1477702579
Provider Name (Legal Business Name): BEULAH FIRE PROTECTION & AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8675 CENTRAL AVE
BEULAH CO
81023-9740
US

IV. Provider business mailing address

PO BOX 826
BEULAH CO
81023-0826
US

V. Phone/Fax

Practice location:
  • Phone: 719-485-2367
  • Fax:
Mailing address:
  • Phone: 719-485-2367
  • Fax: 719-485-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberEMS-2
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: BRYAN RAYMOND WARE
Title or Position: FIRE CHIEF
Credential: NR EMT-P
Phone: 719-485-2367