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General NPI Number Information
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NPI Number | 1558402370
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Entity Type | Organization
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Legal Business Name | TRI-LAKES MONUMENT FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 16055 OLD FOREST PT STE 102
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City | MONUMENT
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State | CO
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Zip | 80132-8670
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Country | US
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Telephone | 719-484-0911
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Fax | 719-481-3456
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Provider Business Mailing Address
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Address Line | 16055 OLD FOREST PT STE 102
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City | MONUMENT
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State | CO
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Zip | 80132-8670
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Country | US
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Telephone | 719-484-0911
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Fax | 719-481-3456
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | ANDY KOVACS
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Credential | AUTHORIZED OFFICIAL
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Telephone | 719-484-0911
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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 | CO
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