Provider Demographics
NPI:1124198064
Name:SNOWMASS-WILDCAT FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:SNOWMASS-WILDCAT FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-319-3129
Mailing Address - Street 1:PO BOX 6436
Mailing Address - Street 2:5275 OWL CREEK ROAD
Mailing Address - City:SNOWMASS VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:81615-6436
Mailing Address - Country:US
Mailing Address - Phone:970-923-2212
Mailing Address - Fax:970-923-2224
Practice Address - Street 1:5275 OWL CREEK ROAD
Practice Address - Street 2:
Practice Address - City:SNOWMASS VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:81615-6436
Practice Address - Country:US
Practice Address - Phone:970-923-2212
Practice Address - Fax:970-923-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49043416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1124198064OtherBLUE CROSS BLUE SHIELD
COC60013Medicare PIN