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NPI 1568418184

NPI 1568418184 : SOUTH METRO FIRE RESCUE : CENTENNIAL, CO

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General NPI Number Information
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    NPI Number           |    1568418184
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    Entity Type          |    Organization 
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    Legal Business Name  |    SOUTH METRO FIRE RESCUE 
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Dates
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    Enumeration Date     |    05/25/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    9195 E MINERAL AVE 
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    City                 |    CENTENNIAL
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    State                |    CO
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    Zip                  |    80112-3554
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    Country              |    US
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    Telephone            |    720-488-7171
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9195 E MINERAL AVE 
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    City                 |    CENTENNIAL
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    State                |    CO
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    Zip                  |    80112-3554
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    EMS CHIEF
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    Name                 |     MARILYN  BOURN 
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    Credential           |    
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    Telephone            |    720-488-7171
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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       |    
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    License Number State |    CO
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