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General NPI Number Information
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NPI Number | 1790760361
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Entity Type | Organization
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Legal Business Name | COUNTY OF GRAND
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 81 W AGATE AVENUE
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City | GRANBY
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State | CO
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Zip | 80446-1457
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Country | US
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Telephone | 970-887-2732
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Fax | 970-887-1698
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Provider Business Mailing Address
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Address Line | P.O. BOX 1457
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City | GRANBY
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State | CO
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Zip | 80446-1457
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Country | US
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Telephone | 970-887-2732
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Fax | 970-887-1698
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Authorized Official
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Title or Position | COUNTY MANAGER
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Name | MR. EDWARD T MOYER
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Credential |
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Telephone | 970-725-3101
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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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