Provider Demographics
NPI:1033258785
Name:NORTH CENTRAL FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:NORTH CENTRAL FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - WIBS
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GADZIALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-525-9287
Mailing Address - Street 1:40144 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DEER TRAIL
Mailing Address - State:CO
Mailing Address - Zip Code:80105-7922
Mailing Address - Country:US
Mailing Address - Phone:303-621-8737
Mailing Address - Fax:
Practice Address - Street 1:40144 RIDGE RD
Practice Address - Street 2:
Practice Address - City:DEER TRAIL
Practice Address - State:CO
Practice Address - Zip Code:80105-7922
Practice Address - Country:US
Practice Address - Phone:303-621-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO83931538Medicaid
501268Medicare UPIN