Provider Demographics
NPI:1093707242
Name:ELOY FIRE DISTRICT
Entity Type:Organization
Organization Name:ELOY FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:COY
Authorized Official - Middle Name:
Authorized Official - Last Name:AMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-466-3544
Mailing Address - Street 1:4010 N TOLTEC RD
Mailing Address - Street 2:
Mailing Address - City:ELOY
Mailing Address - State:AZ
Mailing Address - Zip Code:85131-1400
Mailing Address - Country:US
Mailing Address - Phone:520-466-3544
Mailing Address - Fax:520-466-3095
Practice Address - Street 1:500 S SUNSHINE BLVD
Practice Address - Street 2:
Practice Address - City:ELOY
Practice Address - State:AZ
Practice Address - Zip Code:85131-2420
Practice Address - Country:US
Practice Address - Phone:520-466-3544
Practice Address - Fax:520-466-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ070631Medicaid
AZ070631Medicaid
AZ590003391Medicare ID - Type UnspecifiedRAILROAD MEDICARE