Provider Demographics
NPI:1164759726
Name:GILPIN AMBULANCE AUTHORITY
Entity Type:Organization
Organization Name:GILPIN AMBULANCE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SERVICES OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-582-5499
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:BLACK HAWK
Mailing Address - State:CO
Mailing Address - Zip Code:80422-0638
Mailing Address - Country:US
Mailing Address - Phone:303-582-5499
Mailing Address - Fax:303-582-3390
Practice Address - Street 1:495 APEX RD
Practice Address - Street 2:
Practice Address - City:BLACK HAWK
Practice Address - State:CO
Practice Address - Zip Code:80422
Practice Address - Country:US
Practice Address - Phone:303-582-5499
Practice Address - Fax:303-582-3390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport