Healthcare Provider Details

I. General information

NPI: 1730281775
Provider Name (Legal Business Name): LOS PINOS FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 BROWNING AVENUE
IGNACIO CO
81137
US

IV. Provider business mailing address

PO BOX 319
IGNACIO CO
81137-0319
US

V. Phone/Fax

Practice location:
  • Phone: 970-563-9501
  • Fax: 970-563-9369
Mailing address:
  • Phone: 970-563-9501
  • Fax: 970-563-9369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberNO #
License Number StateCO

VIII. Authorized Official

Name: GREG CHILDRESS
Title or Position: DEPUTY CHIEF
Credential:
Phone: 970-903-2185