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General NPI Number Information
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NPI Number | 1336692342
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Entity Type | Organization
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Legal Business Name | CITY OF PEORIA
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 8351 W CINNABAR AVE ATTN: FIRE-MEDICAL DEPARTMENT
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City | PEORIA
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State | AZ
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Zip | 85345-2701
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Country | US
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Telephone | 623-773-7279
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Fax | 623-773-7295
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Provider Business Mailing Address
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Address Line | 8401 W MONROE ST ATTN: FIRE-MEDICAL DEPARTMENT
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City | PEORIA
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State | AZ
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Zip | 85345-6560
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Country | US
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Telephone | 623-773-7279
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Fax | 623-773-7295
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Authorized Official
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Title or Position | DEPUTY CHIEF OF EMS
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Name | GARY L BERNARD
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Credential | OA
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Telephone | 623-773-7911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 146
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License Number State | AZ
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