Provider Demographics
NPI:1265508105
Name:GOLDEN SHORES FIRE DEPARTMENT
Entity Type:Organization
Organization Name:GOLDEN SHORES FIRE DEPARTMENT
Other - Org Name:GOLDEN SHORES VOLUNTEER FIRE
Other - Org Type:Other Name
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-768-4546
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:TOPOCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86436-0066
Mailing Address - Country:US
Mailing Address - Phone:928-768-4546
Mailing Address - Fax:928-768-4544
Practice Address - Street 1:12950 OATMAN HWY
Practice Address - Street 2:
Practice Address - City:TOPOCK
Practice Address - State:AZ
Practice Address - Zip Code:86436
Practice Address - Country:US
Practice Address - Phone:928-768-4546
Practice Address - Fax:928-768-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance