Provider Demographics
NPI:1407962095
Name:CHARLOTTE COUNTY FIRE EMS
Entity Type:Organization
Organization Name:CHARLOTTE COUNTY FIRE EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR EMS INSURANCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-833-5613
Mailing Address - Street 1:PO BOX 409335
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384
Mailing Address - Country:US
Mailing Address - Phone:305-459-0664
Mailing Address - Fax:305-421-0928
Practice Address - Street 1:26571 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33982-2414
Practice Address - Country:US
Practice Address - Phone:941-833-5613
Practice Address - Fax:941-833-5630
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARLOTTE COUNTY BOARD OF COUNTY COMISSIONERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-23
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL089925900Medicaid
FLA0038Medicare UPIN