Healthcare Provider Details

I. General information

NPI: 1871520817
Provider Name (Legal Business Name): KIM AREA VOLUNTEER FIRE DEPARTMENT AND AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 LAS ANIMAS AVE
KIM CO
81049-0137
US

IV. Provider business mailing address

115 LAS ANIMAS AVE P.O. BOX 137
KIM CO
81049-0137
US

V. Phone/Fax

Practice location:
  • Phone: 719-643-5265
  • Fax: 719-643-5265
Mailing address:
  • Phone: 719-643-5265
  • Fax: 719-643-5265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberLA COUNTY 2005-01
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License NumberLA COUNTY 2005-01
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberLA COUNTY 2005-01
License Number StateCO

VIII. Authorized Official

Name: LON J ROBERTSON
Title or Position: BOARD CHAIR
Credential:
Phone: 719-643-5265