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General NPI Number Information
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NPI Number | 1801873104
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Entity Type | Organization
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Legal Business Name | TRI CITY FIRE DISTRICT
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 4280 E BROADWAY
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City | CLAYPOOL
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State | AZ
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Zip | 85532
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Country | US
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Telephone | 928-473-2362
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Fax | 928-473-2991
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Provider Business Mailing Address
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Address Line | PO BOX 63068
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City | PHOENIX
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State | AZ
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Zip | 85082-3068
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Country | US
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Telephone | 602-437-1431
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Fax | 602-437-8436
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | MR. MARCO R OLSEN
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Credential |
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Telephone | 928-473-2362
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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 | 126
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License Number State | AZ
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