MEDICARE: PICTURE ROCKS FIRE DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AZ0151080	OTHER	AZ	BLUE CROSS

General Provider Information

NPI Number	:	1144223660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PICTURE ROCKS FIRE DISTRICT

Provider Business Mailing Address
First Line	:	12121 W PICTURE ROCKS RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-9722
Country	:	US
Telephone Number	:	520-682-7878
Fax Number	:	520-682-0421

Provider Business Practice Location Address
First Line	:	12121 W PICTURE ROCKS RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-9722
Country	:	US
Telephone Number	:	520-682-7878
Fax Number	:	520-682-0421

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	LEONARD BRETT LANE
Credential	:
Telephone Number	:	520-682-7878

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	01/04/2013

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Directions to “PICTURE ROCKS FIRE DISTRICT ” Practice Location

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