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General NPI Number Information
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NPI Number | 1235394693
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Entity Type | Organization
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Legal Business Name | CADDO PARISH FIRE DISTRICT #5
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Dates
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Enumeration Date | 07/25/2008
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 1675 LEONARD RD
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City | SHREVEPORT
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State | LA
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Zip | 71115-8583
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Country | US
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Telephone | 318-797-4111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 52985
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City | SHREVEPORT
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State | LA
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Zip | 71135-2985
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Country | US
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Telephone | 318-797-4111
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Fax |
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | GRAYSON S BOUCHER
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Credential |
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Telephone | 318-797-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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