Healthcare Provider Details

I. General information

NPI: 1356438378
Provider Name (Legal Business Name): AMERICAN FORK CITY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 NORTH CENTER ST.
AMERICAN FORK UT
84003-1626
US

IV. Provider business mailing address

96 NORTH CENTER ST.
AMERICAN FORK UT
84003-1626
US

V. Phone/Fax

Practice location:
  • Phone: 801-763-3000
  • Fax: 801-763-3011
Mailing address:
  • Phone: 801-763-3000
  • Fax: 801-763-3011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number2540L
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number2501L
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number2501L
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. KRISS GARCIA
Title or Position: FIRE CHIEF
Credential:
Phone: 801-763-3045