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General NPI Number Information
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NPI Number | 1942393517
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Entity Type | Organization
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Legal Business Name | FORT MOJAVE MESA FIRE DEPARTMENT
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 2230 JOY LN
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City | FORT MOHAVE
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State | AZ
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Zip | 86426-6625
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Country | US
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Telephone | 928-768-9181
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Fax | 928-768-8434
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Provider Business Mailing Address
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Address Line | 2230 JOY LN P.O. BOX 8488
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City | FORT MOHAVE
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State | AZ
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Zip | 86426-6625
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Country | US
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Telephone | 928-768-9181
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Fax | 928-768-8434
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Authorized Official
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Title or Position | BATTALION CHIEF
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Name | MR. STEVE A WEST
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Credential |
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Telephone | 928-768-9181
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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 | 82
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License Number State | AZ
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