Healthcare Provider Details

I. General information

NPI: 1508949686
Provider Name (Legal Business Name): CADDO PARISH FIRE DISTRICT NO. SIX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11450 OLD MANSFIELD ROAD
KEITHVILLE LA
71047
US

IV. Provider business mailing address

PO BOX 292
KEITHVILLE LA
71047-0292
US

V. Phone/Fax

Practice location:
  • Phone: 318-925-8791
  • Fax: 318-925-8799
Mailing address:
  • Phone: 318-925-8791
  • Fax: 318-925-8799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number09068
License Number StateLA

VIII. Authorized Official

Name: MR. DAMON JOHNSON
Title or Position: FIRE CHIEF
Credential:
Phone: 318-925-8791