Healthcare Provider Details

I. General information

NPI: 1902919855
Provider Name (Legal Business Name): BIG SANDY FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 SIOUX AVE
SIMLA CO
80835-0161
US

IV. Provider business mailing address

511 COLORADO AVE
CALHAN CO
80808-8699
US

V. Phone/Fax

Practice location:
  • Phone: 719-541-2883
  • Fax: 719-541-3148
Mailing address:
  • Phone: 719-347-9309
  • Fax: 719-347-9311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PETER MARKLE
Title or Position: OFFICER
Credential:
Phone: 719-541-2883