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General NPI Number Information
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NPI Number | 1679532535
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Entity Type | Organization
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Legal Business Name | SIERRA VISTA FRY FIRE DISTRICT
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 04/24/2020
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Provider Practice Location Address
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Address Line | 4817 S APACHE AVE
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City | SIERRA VISTA
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State | AZ
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Zip | 85650
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Country | US
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Telephone | 520-378-3276
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Fax | 520-378-0227
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Provider Business Mailing Address
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Address Line | 4817 S APACHE AVE
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City | SIERRA VISTA
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State | AZ
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Zip | 85650-9702
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Country | US
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Telephone | 520-378-3276
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Fax | 520-378-0227
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | DIANA JONES
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Credential | CAC
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Telephone | 520-378-3276
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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 | 18
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License Number State | AZ
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