Provider Demographics
NPI:1184650582
Name:CITY OF THORNTON
Entity Type:Organization
Organization Name:CITY OF THORNTON
Other - Org Name:THORNTON FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT CHIEF EMS
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-538-7602
Mailing Address - Street 1:9500 CIVIC CENTER DR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4326
Mailing Address - Country:US
Mailing Address - Phone:303-538-7602
Mailing Address - Fax:303-538-7660
Practice Address - Street 1:9500 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4326
Practice Address - Country:US
Practice Address - Phone:303-538-7602
Practice Address - Fax:303-538-7660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18474543Medicaid
CO18474543Medicaid