Provider Demographics
NPI:1235199159
Name:LAYTON CITY CORPORATION
Entity Type:Organization
Organization Name:LAYTON CITY CORPORATION
Other - Org Name:LAYTON CITY FIRE DEPT AMBULANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-336-3940
Mailing Address - Street 1:437 WASATCH DR
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-3275
Mailing Address - Country:US
Mailing Address - Phone:801-336-3940
Mailing Address - Fax:801-546-0901
Practice Address - Street 1:530 N 2200 W
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-7249
Practice Address - Country:US
Practice Address - Phone:801-336-3940
Practice Address - Fax:801-546-0901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT0607L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========008Medicaid
UT=========008Medicaid
UT000009065Medicare ID - Type Unspecified