Provider Demographics
NPI:1275671356
Name:TOWN OF PALISADE
Entity Type:Organization
Organization Name:TOWN OF PALISADE
Other - Org Name:PALISAADE FIRE AND RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREAS
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-464-5602
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:PALISADE
Mailing Address - State:CO
Mailing Address - Zip Code:81526-0128
Mailing Address - Country:US
Mailing Address - Phone:800-300-9815
Mailing Address - Fax:
Practice Address - Street 1:175 EAST 3RD STREET
Practice Address - Street 2:
Practice Address - City:PALISADE
Practice Address - State:CO
Practice Address - Zip Code:81526
Practice Address - Country:US
Practice Address - Phone:970-464-5602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPALISADE VFD3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC63393Medicare ID - Type Unspecified