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General NPI Number Information
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NPI Number | 1750616447
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Entity Type | Organization
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Legal Business Name | PUEBLO WEST METROPOLITAN DISTRICT
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Dates
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Enumeration Date | 10/13/2009
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 51 E HAHNS PEAK AVE
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City | PUEBLO WEST
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State | CO
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Zip | 81007-2660
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Country | US
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Telephone | 719-547-7337
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Fax | 719-547-1769
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Provider Business Mailing Address
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Address Line | PO BOX 7005
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City | PUEBLO WEST
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State | CO
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Zip | 81007-0005
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Country | US
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Telephone | 719-547-7337
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Fax | 719-547-1769
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | BRIAN CASERTA
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Credential |
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Telephone | 719-547-7337
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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 | EMS-5
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License Number State | CO
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