Provider Demographics
NPI:1235394693
Name:CADDO PARISH FIRE DISTRICT #5
Entity Type:Organization
Organization Name:CADDO PARISH FIRE DISTRICT #5
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:GRAYSON
Authorized Official - Middle Name:S
Authorized Official - Last Name:BOUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-797-4111
Mailing Address - Street 1:PO BOX 52985
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71135-2985
Mailing Address - Country:US
Mailing Address - Phone:318-797-4111
Mailing Address - Fax:
Practice Address - Street 1:1675 LEONARD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-8583
Practice Address - Country:US
Practice Address - Phone:318-797-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport