Provider Demographics
NPI:1114195872
Name:HOLLY FIRE & AMBULANCE DISTRICT
Entity Type:Organization
Organization Name:HOLLY FIRE & AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RUSHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-537-9034
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:CO
Mailing Address - Zip Code:81047-0213
Mailing Address - Country:US
Mailing Address - Phone:719-537-9034
Mailing Address - Fax:
Practice Address - Street 1:115 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:CO
Practice Address - Zip Code:81047
Practice Address - Country:US
Practice Address - Phone:719-537-9034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO200723416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport