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General NPI Number Information
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NPI Number | 1629346358
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Entity Type | Organization
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Legal Business Name | AGATE FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 04/08/2013
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Provider Practice Location Address
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Address Line | 40160 COUNTY ROAD 153
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City | AGATE
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State | CO
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Zip | 80101
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Country | US
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Telephone | 719-764-2771
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Fax |
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Provider Business Mailing Address
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Address Line | 40160 COUNTY ROAD 153
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City | AGATE
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State | CO
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Zip | 80101
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Country | US
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Telephone | 719-764-2771
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Fax |
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Authorized Official
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Title or Position | CHIEF
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Name | MR. LARRY G RECTOR
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Credential |
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Telephone | 719-740-1989
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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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