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General NPI Number Information
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NPI Number | 1902056864
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Entity Type | Organization
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Legal Business Name | NORTHWEST FREMONT EMS, INC.
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 110 SOUTH BND
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City | CANON CITY
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State | CO
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Zip | 81212-9772
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Country | US
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Telephone | 719-275-3450
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Fax | 719-275-4350
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Provider Business Mailing Address
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Address Line | 110 SOUTH BND
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City | CANON CITY
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State | CO
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Zip | 81212-9772
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Country | US
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Telephone | 719-275-3450
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Fax | 719-275-4350
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Authorized Official
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Title or Position | TREASURER
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Name | TONYA R HECOX
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Credential | EMT-I
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Telephone | 719-275-3450
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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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