Provider Demographics
NPI:1144223660
Name:PICTURE ROCKS FIRE DISTRICT
Entity Type:Organization
Organization Name:PICTURE ROCKS FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:BRETT
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-682-7878
Mailing Address - Street 1:12121 W PICTURE ROCKS RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-9722
Mailing Address - Country:US
Mailing Address - Phone:520-682-7878
Mailing Address - Fax:520-682-0421
Practice Address - Street 1:12121 W PICTURE ROCKS RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-9722
Practice Address - Country:US
Practice Address - Phone:520-682-7878
Practice Address - Fax:520-682-0421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-30
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ072009Medicaid
AZAZ0151080OtherBLUE CROSS
AZAZ0151080OtherBLUE CROSS
AZ072009Medicaid