Healthcare Provider Details

I. General information

NPI: 1073705349
Provider Name (Legal Business Name): CALHAN FIRE PROTECTION DIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 4TH STREET
CALHAN CO
80808-0188
US

IV. Provider business mailing address

PO BOX 188
CALHAN CO
80808-0188
US

V. Phone/Fax

Practice location:
  • Phone: 719-347-3057
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TERESA O'LEAR
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 719-347-9309