MEDICARE: NORTHWEST 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	AZ CON 138	AZ

General Provider Information

NPI Number	:	1316331374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST FIRE DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 205932
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-5932
Country	:	US
Telephone Number	:	877-865-8417
Fax Number	:	888-974-1293

Provider Business Practice Location Address
First Line	:	5225 W MASSINGALE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-8416
Country	:	US
Telephone Number	:	877-865-7417
Fax Number	:	888-974-1293

Authorized Official
Title or Position	:	DIVISION CHIEF
Name	:	MR. SCOTT DRAPER
Credential	:
Telephone Number	:	520-887-1010

Provider Enumeration Date	:	03/26/2015
Last Update Date	:	09/05/2018

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Directions to “NORTHWEST FIRE DISTRICT ” Practice Location

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