Provider Demographics
NPI:1326181223
Name:AVRA VALLEY FIRE DISTRICT
Entity Type:Organization
Organization Name:AVRA VALLEY FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELFS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-682-3255
Mailing Address - Street 1:15790 W SILVERBELL RD
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-9577
Mailing Address - Country:US
Mailing Address - Phone:520-682-3255
Mailing Address - Fax:520-682-5458
Practice Address - Street 1:15790 W SILVERBELL RD
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85653-9577
Practice Address - Country:US
Practice Address - Phone:520-682-3255
Practice Address - Fax:520-682-5458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ071754Medicaid
AZAY6294Medicare UPIN
AZ071754Medicaid
AZZRFBGXMedicare ID - Type UnspecifiedMEDICARE ID NUMBER